Alcohol-related harm taking a toll in hospital emergency departments—more than half a million admissions each year

A world-first research study investigating the burden of alcohol harm has revealed that almost one in ten presentations to hospital emergency departments is alcohol-related.

Led by Monash University researcher and Monash Health Director of Emergency Medicine Research Associate Professor Diana Egerton-Warburton, the first large-scale international, multisite, prospective study into the total burden of alcohol harm presenting to emergency departments (EDs) shows the burden is higher than previously thought.

Alcohol is a major cause of death and disability internationally, resulting in an estimated 5.9% of all deaths.

Associate Professor Egerton-Warburton said alcohol-related harm accounts for 3.3 million deaths annually and is also linked to over 200 diseases.

“EDs are at the frontline of treating the health and social consequences of alcohol-related harm,” Associate Professor Egerton-Warburton said.

“Our study is the first in the world to include the total burden of alcohol-related harm, including physical injuries, intoxication, medical conditions and indirect injuries caused by a third party affected by alcohol.”

“It’s shocking that more than half a million people every year present to our EDs in Australia as a direct result of alcohol—bearing in mind these are preventable admissions.”

Eight hospital EDs across Australia and New Zealand—representing metropolitan, rural and regional populations—screened nearly 8500 patients over a seven-day period in December 2014.  Of these, 801 presentations (or 9.5%), were identified as being alcohol positive according to the study criteria.

“These findings verify previous data that demonstrated high levels of alcohol-related presentations overnight during weekends, but also demonstrate that patients with alcohol-related conditions are presenting to EDs at all times throughout the week,” Associate Professor Egerton-Warburton said.

Patients with alcohol-related harm are more likely to be younger, male, be triaged for immediate care, and arrive via ambulance or police.

Associate Professor Egerton-Warburton said these types of patients are resource intensive, and may be violent and aggressive to staff and other patients.

“They have been found to disrupt the function of the ED and negatively impact on the care of other patients,” she said.

“Our previously published clinical survey found that nine out of 10 emergency clinicians had experienced violence from alcohol-affected patients over the last year.”

“Alcohol consumption has a significant impact on the healthcare system as reflected in the prevalence of alcohol-related presentations occurring daily in our EDs, and as alcohol-related harm is an inherently preventable condition, this represents a strong case for preventative public health interventions,” Associate Professor Egerton-Warburton said.

“Restricting the availability of alcohol through early closing of licenced venues has demonstrated a significant reduction in ED alcohol-related presentations internationally.”

Associate Professor Egerton-Warburton said this research adds to the compelling argument for widespread introduction of restricted trading hours to reduce harms and healthcare costs.