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Impact of alcohol consumption upon medical care utilization and costs in men: 4-year observation of National Health Insurance beneficiaries in Japan.

Anzai Y, Kuriyama S, Nishino Y, Takahashi K, Ohkubo T, Ohmori K, Tsubono Y, Tsuji I

Research Unit for Public Health Nursing, Miyagi University School of Nursing, Miyagi, Japan. anzai@myu.ac.jp

AIMS: The purpose of the present study was to examine the association between alcohol consumption and in-patient and out-patient care utilization and its costs, respectively. DESIGN AND PARTICIPANTS: The present data were derived from a 4-year prospective observation of National Health Insurance beneficiaries in rural Japan. A total of 17 497 men aged 40-79 years were analysed, after excluding subjects who at the baseline reported having had at least one of four chronic diseases: stroke, myocardial infarction, liver disease and cancer. Alcohol intake was classified into five groups, not including ex-drinkers: life-long abstainers and ethanol intakes of 1-149 g/week, 150-299 g/week, 300-449 g/week, and > or = 450 g/week. FINDINGS: The hospital days and in-patient care cost showed a U-shaped relationship with alcohol consumption. In-patient cost was highest for those consuming more than 450 g/week [ pound 74.96, 95% confidence interval (CI): 54.39, 95.52] and for life-long abstainers ( pound 69.16, 95% CI: 62.08, 77.83), and lowest for those consuming 150-299 g/week ( pound 51.69, 95% CI: 45.33, 58.04). In-patient use by age specific analysis also showed a U-shape at all ages, and was lowest for those consuming 1-149 g/week in youngest age group. In contrast, the number of physician visits and out-patient cost showed an inverse linear relationships with alcohol consumption. CONCLUSIONS: This study suggests that in-patient use shows a U-shaped curve and out-patient use shows an inverse linear relationship to alcohol consumption.

Published 15 December 2004 in Addiction, 100(1): 19-27.
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