Objective: The purpose of this study was to examine differences between healthcare use and associated costs in rural and urban at-risk drinkers. Method: Primary healthcare utilization and cost data were collected from 1995 to 1998 on rural (n = 215) and urban (n = 228) cohorts of drinkers residing in six southeastern states who met criteria for at-risk drinking. Data were obtained through subject interview and from abstracts of medical and pharmacy records. Results: Overall healthcare costs were not significantly different between the rural and urban cohorts. For subjects who incurred any hospital costs (including emergency room [ER] visits), however, costs were significantly greater (p < .01) for rural patients (median = $2,561) than for urban patients (median = $865). Hospital costs associated with patients' ER visits and any subsequent admissions were also greater (p < .01) for rural patients (median= $1,004) than for urban patients (median= $512). Use of healthcare services was significantly more likely to occur among women (p < .0001), individuals with lower overall self-reported physical health (p < .01) and individuals with health insurance (p < .0001). Among subjects who used healthcare services, greater costs were significantly associated with older age (p <. 05), being female (p < .0001), having lower overall physical health (p < .0001) and having health insurance (p < .01). Conclusions: While overall healthcare costs are not significantly different between rural and urban residents in this sample of at-risk drinkers, there are some notable differences in the costs associated with inpatient and ER services.
ASJC Scopus subject areas
- Medicine (miscellaneous)