U.S. Alcohol Epidemiologic Data Reference Manual, Volume 9
Alcohol-Related Emergency Department Visits and Hospitalizations and
Their Co-Occurring Drug-Related, Mental Health, and Injury Conditions in the United States: Findings from the 2006–2010 Nationwide Emergency Department Sample (NEDS) and Nationwide Inpatient Sample (NIS)
September 2013
National Institutes of Health
National Institute on Alcohol Abuse and Alcoholism
5635 Fishers Lane, MSC 9304
Bethesda, MD 20892‑9304
Acknowledgments
This publication was developed by CSR, Incorporated, under Contract No. HHSN267200800023 for the operation of the Alcohol Epidemiologic Data System (AEDS) for the Division of Epidemiology and Prevention Research (DEPR) of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH). Principal authors of this manual are Chiung M. Chen, M.A., Young-Hee Yoon, Ph.D., and Hsiao-ye Yi, Ph.D., of CSR. Ralph W. Hingson, Sc.D., Director of DEPR, contributed to the conceptualization of this manual. Aaron M. White, Ph.D., and Rosalind A. Breslow, Ph.D., of DEPR reviewed the draft. Dr. Breslow also served as NIAAA’s Project Officer on the above-referenced contract and oversaw the completion of this manual.
NIH Publication No. 13‑8000
Foreword
The National Institute on Alcohol Abuse and Alcoholism (NIAAA), a part of the National Institutes of Health, is the primary Federal agency that conducts and supports epidemiologic, biomedical and behavioral research related to the causes, consequences, treatment, and prevention of alcohol-related problems.
The Alcohol Epidemiologic Data Reference Manuals (AEDRMs) produced by the Alcohol Epidemiologic Data System (AEDS) of NIAAA provide detailed epidemiologic data useful to researchers, health care planners, and others interested in the topics of alcohol use, abuse, and associated morbidity and mortality.
This manual is the first publication in Volume 9 of the AEDRM series, presenting an extensive compilation of data on alcohol-related emergency department visits and hospitalizations and their co-occurring drug-related conditions, mental health disorders, and injuries. The source data for the manual came from the 2006–2010 Nationwide Emergency Department Sample (NEDS) and Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP), sponsored by Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services. The NEDS and the NIS are the largest national databases of hospital-based emergency department (ED) visits and hospital inpatient stays in the United States.
Other volumes of the AEDRM series include information on alcohol use and alcohol use disorders, per capita alcohol consumption, liver cirrhosis mortality, county alcohol-problem indicators, hospital discharges with alcohol-related conditions, and State trends in drinking behaviors and alcohol-related mortality. We hope that these documents will serve as a useful reference for both researchers and others interested in the alcoholism field.
Kenneth R. Warren, Ph.D.
Acting Director
National Institute on Alcohol Abuse and Alcoholism
1. Introduction
This manual presents national statistics on alcohol-related morbidity in the United States based on patient data from emergency department (ED) visits and hospital discharge records. It was compiled and published by the Alcohol Epidemiologic Data System (AEDS) of the Division of Epidemiology and Prevention Research (DEPR), National Institute on Alcohol Abuse and Alcoholism (NIAAA) as part of a series of alcohol epidemiologic data reference manuals. These manuals serve as tools for monitoring trends in alcohol consumption and related problems. While several of the earlier manuals have focused on alcohol-related mortality (Caces, Stinson, & Elliott, 1991; Grant, 1985; Stinson & Nephew, 1996; Stinson & Proudit, 1994), none have yet reported data on alcohol-related morbidity and comorbidity. One of the NIAAA surveillance reports that AEDS has maintained since 1987 reports trends in alcohol-related morbidity based on data from the annual National Hospital Discharge Survey conducted by the National Center for Health Statistics (NCHS), but using hospital discharge data alone misses a substantial proportion of patients who are treated in emergency rooms. To expand our morbidity surveillance to alcohol-related emergency department (ED) visits, this manual presents the recently available data from the Nationwide Emergency Department Sample (NEDS) as well as the Nationwide Inpatient Sample (NIS). Together, these two databases provide a more complete picture of health care utilization for alcohol-related health problems.
This manual is the first to present the prevalence of co-occurrence of drug-related, mental health-related, and injury-related diagnoses among alcohol-related ED visits and hospitalizations. In addition, it provides short trends in ED visits and hospitalization rates for several specific alcohol-related diagnoses, including alcoholic psychoses, alcohol dependence syndrome, nondependent abuse of alcohol, chronic liver diseases and cirrhosis, and alcohol poisoning, as well as their co-occurring conditions for drug-related, mental health-related, and injury-related diagnoses. Against the backdrop of overcrowding of ED health care services (Institute of Medicine, 2004) and a rising trend of utilization among patients with mental health and substance use disorders in the ED setting (Larkin et al., 2005), this manual is timely and especially relevant for the intervention and prevention purposes.
2. Data Sources
2.1. Emergency Department (ED) Visit and Hospitalization Data
The data presented in this manual are based on the annual ED and hospitalization data from the Nationwide Emergency Department Sample (NEDS) and the Nationwide Inpatient Sample (NIS) respectively, from 2006 to 2010. The NEDS and the NIS are part of the Healthcare Cost and Utilization Project (HCUP), a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services. The NEDS and the NIS are unique and powerful databases of emergency department visits and of hospital inpatient stays, respectively. Researchers and policymakers use the NEDS and the NIS to identify, track, and analyze national and regional trends in hospital emergency department and hospital care utilization, access, charges, and quality.
The NEDS is the largest publicly available all-payer ED database in the United States, containing discharge information on all ED visits from a stratified sample of hospital-based EDs in the participating states that provide the HCUP with ED data. The NEDS is constructed using records from two sets of the HCUP state databases: the State Emergency Department Databases (SEDD) and the State Inpatient Databases (SID). The SEDD capture information on more than 80% of ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). The SID capture information on patients initially seen in the emergency room and then admitted to the same hospital. Accordingly, the NEDS provides information on care that began in the emergency department, regardless of whether the patients were treated and released or admitted to the hospital. Each year the NEDS contains about 25 to 30 million records for ED visits from over 950 hospitals, approximating a 20-percent stratified sample of U.S. hospital-based EDs. The numbers of EDs included in the NEDS from 2006 to 2010 are 955, 966, 980, 964, and 961, respectively. The numbers of participating states included in the NEDS from 2006 to 2010 are 24, 27, 28, 29, and 28, respectively.
The NIS is the largest publicly available all-payer inpatient care database in the United States, containing discharge information on all inpatient stays from a 20% stratified sample of hospitals in the states that participated in the HCUP. The NIS is constructed using records from the SID. Each year the NIS contains about 8 million records for inpatient stays from about 1,000 hospitals, approximating a 20-percent stratified sample of U.S. community hospitals. The numbers of hospitals included in the NIS from 2006 to 2010 are 1045, 1044, 1056, 1050, and 1051, respectively. The numbers of participating states included in the NIS from 2006 to 2010 are 30, 40, 42, 44, and 45, respectively.
Both the NEDS and NIS samples are based on U.S. community hospitals. The U.S. community hospitals are identified by the American Hospital Association (AHA) Annual Survey of Hospitals to be “all non-Federal, short-term, general, and other specialty hospitals, excluding hospital units of institutions.” Included among community hospitals are specialty hospitals such as obstetrics-gynecology, ear-nose-throat, short-term rehabilitation, orthopedic, and pediatric institutions. Also included are public hospitals, academic medical centers, and long-term acute care facilities. These facilities provide acute care services to patients who need long-term hospitalization (stays of more than 25 days). Excluded are short-term rehabilitation hospitals, long-term non-acute care hospitals, psychiatric hospitals, and alcoholism/chemical dependency treatment facilities.
The NEDS and the NIS share a similar sampling design referred to as the stratified, single-stage cluster sampling. A stratified random sample of hospital-based EDs (or hospitals) is drawn from the sampling frame (namely SEDD and SID for NEDS, and SID for NIS), and then all ED visits from selected hospital-based EDs (or discharges from hospitals) are included. Stratifying the hospital-based EDs (or hospitals) on important hospital-based ED (or hospital) characteristics ensures that the stratified sample is representative of the target universe—all U.S. community hospital-based EDs for the NEDS, and all U.S. community hospitals for the NIS.
Five hospital characteristics are used as stratifiers for creating the NEDS and the NIS samples. Four of these are the same for both samples: U.S. regions (Northeast, Midwest, West, or South); location (urban or rural); teaching status (teaching or non-teaching); and ownership (government non-Federal or public, private not-for-profit or voluntary, or private investor-owned or proprietary). The fifth stratifier for the NIS is hospital bed size (small, medium, or large, based on the number of hospital beds) and for the NEDS is the trauma center designation (level I, II, and III). A trauma center is a hospital equipped to provide comprehensive emergency medical services to patients with traumatic injuries 24 hours a day, 365 days per year. The trauma-level designation is a modified version of the Trauma Information Exchange Program (TIEP) trauma-level designation. Once the institutions (i.e., hospital-based EDs or hospitals) have been stratified, a 20-percent random sample is taken, and all patient records in these institutions will be used to construct the NEDS and the NIS.
It is important to note that the NEDS and the NIS contain event-level or discharge-level records, not patient-level records. This means that individual patients who visit the ED multiple times in 1 year may be present in the NEDS multiple times, and that individual patients who are hospitalized multiple times in 1 year may be present in the NIS multiple times. Therefore, estimates generated from these databases are referred to as ED visits or hospitalizations rather than patients.
The ED visit or discharge weight variable provided in the NEDS or NIS database is applied to the data tables in this manual to produce national or regional representative estimates. To indicate the precision of the estimates, standard errors are presented. Standard errors can be used to determine if differences between two estimates are statistically significant, or to construct confidence intervals for sample estimates of population statistics. The Taylor-series linearization method was used to calculate standard errors, taking into account the cluster and stratification aspects of the NEDS and NIS sample design using SUDAAN (Research Triangle Institute, 2008), a computer program that uses appropriate statistical techniques to adjust for sample design effects.
Interested readers may consult the HCUP Website, http://www.hcup-us.ahrq.gov, for more thorough descriptions about the NEDS and the NIS and for detailed information on the weighting of these databases and the calculation of standard errors.
2.2. Population Data
To calculate population-based rates in this manual, population data were used as the denominator while numbers estimated from the NEDS and the NIS were used as the numerator. The population data used in this manual were obtained from the U.S. Census Bureau, including Intercensal Estimates of the Resident Population by Single Year of Age and Sex for States and the United States: April 1, 2000 to July 1, 2010 (U.S. Census Bureau, 2011a) and Intercensal Estimates of the Resident Population for the United States, Regions, States, and Puerto Rico: April 1, 2000 to July 1, 2010 (U.S. Census Bureau, 2011b).
3. Data Coverage
Data provided in this manual cover four broad categories of medical conditions—alcohol-related diagnoses plus three co-occurring condition categories (drug-related diagnoses, mental health-related diagnoses, and injury diagnoses) among ED visits and hospital discharges of persons ages 12 and older. The medical conditions are ascertained by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) as indicated on patient discharge records in the NEDS and the NIS. Exhibits 1–4 list the ICD-9-CM codes used in this manual to define the four broad categories (and their subcategories), respectively.
On each patient record, the NEDS contains up to 15 diagnoses, and the NIS contains up to 25 diagnoses (15 before the 2009 NIS). In this manual, health condition categories are presented as the first-listed diagnoses as well as all-listed diagnoses. For hospital-based inpatient services, the first-listed diagnosis is the principal diagnosis, defined by the ICD-9-CM coding guidelines as the “condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care.” For hospital-based ED services, the first-listed diagnosis would be the “code for the diagnosis, condition, problem or other reason for encounter/visit shown in the medical record to be chiefly responsible for the services provided” (Senathirajah et al., 2011). To qualify for an all-listed diagnosis of a certain condition category, any one of the ICD-9-CM codes for that condition category appearing as a diagnosis on the discharge record, regardless of its location, would suffice. There are also up to four external cause-of-injury codes (E-codes) retained in separate data elements on each patient record. For injury or poisonings that were indicated by E-codes, the identification of these cases was based on all available E-codes on the discharge records, because the first-listed E-code is not necessarily the underlying or principal cause of the injury. In this manual, the number and rate for all-listed diagnoses pertain to the count of events (either ED visits or hospital stays) that involve one or more diagnoses for a given condition category, not the count of diagnoses.
|
Alcohol-Related Diagnoses |
Classification Codes in ICD-9-CM |
|
|---|---|---|
|
Note: Alcohol-related diagnosis codes were selected according to NIAAA’s surveillance report on alcohol-related morbidity (Chen & Yi, 2012). Alcohol poisoning was included according to NCHS’s definition of alcohol-induced conditions (Murphy, 2000). |
||
|
Alcoholic psychoses |
291.0 |
Alcohol withdrawal delirium |
|
291.1 |
Alcohol amnestic syndrome |
|
|
291.2 |
Other alcoholic dementia |
|
|
291.3 |
Alcohol withdrawal hallucinosis |
|
|
291.4 |
Idiosyncratic alcohol intoxication |
|
|
291.5 |
Alcoholic jealousy |
|
|
291.8 |
Other specified alcoholic psychosis |
|
|
291.9 |
Unspecified alcoholic psychosis |
|
|
Alcohol dependence syndrome |
303.0 |
Acute alcoholic intoxication |
|
303.9 |
Other and unspecified alcohol dependence |
|
|
357.5 |
Alcoholic Polyneuropathy |
|
|
425.5 |
Alcoholic Cardiomyopathy |
|
|
535.3 |
Alcoholic Gastritis |
|
|
Nondependent abuse of alcohol |
305.0 |
Nondependent abuse of alcohol |
|
Chronic liver disease and cirrhosis |
|
|
|
Alcoholic liver disease |
571.0 |
Alcoholic fatty liver |
|
571.1 |
Acute alcoholic hepatitis |
|
|
571.2 |
Alcoholic cirrhosis of liver |
|
|
571.3 |
Alcoholic liver damage, unspecified |
|
|
Other specified liver cirrhosis without mention of alcohol |
571.4 |
Chronic hepatitis |
|
571.6 |
Biliary cirrhosis |
|
|
571.8 |
Other chronic nonalcoholic liver disease |
|
|
572.3 |
Portal hypertension |
|
|
Unspecified liver cirrhosis without mention of alcohol |
571.5 |
Cirrhosis of liver without mention of alcohol |
|
571.9 |
Unspecified chronic liver disease without mention of alcohol |
|
|
Alcohol poisoning |
790.3 |
Excessive blood level of alcohol |
|
980 |
Toxic effect of alcohol |
|
|
E860 |
Accidental poisoning by alcohol, n.e.c. |
|
|
Drug-Related Diagnoses |
Classification Codes in ICD-9-CM |
|
|---|---|---|
|
Note: Drug-related diagnosis codes were selected according to NCHS’s definition of drug-induced conditions (Murphy, 2000). |
||
|
Drug psychoses |
292.0 |
Drug withdrawal syndrome |
|
292.1 |
Paranoid and/or hallucinatory states related by drugs |
|
|
292.2 |
Pathological drug intoxication |
|
|
292.8 |
Other specified drug-related mental disorders |
|
|
292.9 |
Unspecified drug-related mental disorder |
|
|
Drug dependence |
304.0 |
Opioid type dependence |
|
304.1 |
Barbiturate and similarly acting sedative or hypnotic dependence |
|
|
304.2 |
Cocaine dependence |
|
|
304.3 |
Cannabis dependence |
|
|
304.4 |
Amphetamine and other psychostimulant dependence |
|
|
304.5 |
Hallucinogen dependence |
|
|
304.6 |
Other specified drug dependence |
|
|
304.7 |
Combinations of opioid type drug with any other |
|
|
304.8 |
Combination of drug dependence excluding opioid type drug |
|
|
304.9 |
Unspecified drug dependence |
|
|
Nondependent abuse of drugs |
305.2 |
Cannabis abuse |
|
305.3 |
Hallucinogen abuse |
|
|
305.4 |
Barbiturate and similarly acting sedative or hypnotic abuse |
|
|
305.5 |
Opioid abuse |
|
|
305.6 |
Cocaine abuse |
|
|
305.7 |
Amphetamine or related acting sympathomimetic abuse |
|
|
305.8 |
Antidepressant type abuse |
|
|
305.9 |
Other, mixed, or unspecified drug abuse |
|
|
Poisoning by drugs, medicinal and biological substances |
960 |
Poisoning by antibiotics |
|
961 |
Poisoning by other anti-infectives |
|
|
962 |
Poisoning by hormones and synthetic substitutes |
|
|
963 |
Poisoning primarily systemic agents |
|
|
964 |
Poisoning by agents primarily affecting blood constituents |
|
|
965 |
Poisoning by analgesic, antipyretics, and antirheumatics |
|
|
966 |
Poisoning by anticonvulsants and anti-parkinsonism drugs |
|
|
967 |
Poisoning by sedatives and hypnotics |
|
|
968 |
Poisoning by other central nervous system depressants and anesthetics |
|
|
969 |
Poisoning by psychotropic agents |
|
|
970 |
Poisoning by central nervous system stimulants |
|
|
971 |
Poisoning by drugs primarily affecting the autonomic nervous system |
|
|
972 |
Poisoning by agents primarily affecting the cardiovascular system |
|
|
973 |
Poisoning by agents primarily affecting the gastrointestinal system |
|
|
974 |
Poisoning by water, mineral, and uric acid metabolism drugs |
|
|
975 |
Poisoning by agents primarily acting on the smooth and skeletal muscles and respiratory system |
|
|
976 |
Poisoning by agents primarily affecting skin and mucous membrane, ophthalmological, otorhinolaryngological, and dental drugs |
|
|
977 |
Poisoning by other and unspecified drugs and medicinal substances |
|
|
978 |
Poisoning by bacterial vaccines |
|
|
979 |
Poisoning by other vaccines and biological substances |
|
|
Accidental drug poisoning |
E850 |
Analgesics, antipyretics, and antirheumatics |
|
E851 |
Barbiturates |
|
|
E852 |
Other sedatives and hypnotics |
|
|
E853 |
Tranquilizers |
|
|
E854 |
Other psychotropic agents |
|
|
E855 |
Other drugs acting on central and autonomic nervous system |
|
|
E856 |
Antibiotics |
|
|
E857 |
Other anti-infectives |
|
|
E858 |
Other drugs |
|
|
Suicidal drug poisoning |
E950.0 |
Analgesics, antipyretics, and antirheumatics |
|
E950.1 |
Barbiturates |
|
|
E950.2 |
Other sedatives and hypnotics |
|
|
E950.3 |
Tranquilizers and other psychotropic agents |
|
|
E950.4 |
Other specified drugs and medicinal substances |
|
|
E950.5 |
Unspecified drug or medicinal substance |
|
|
Assault by drugs and medicinal substances |
E962.0 |
Assault by drugs and medicinal substances |
|
Poisoning by solid or liquid substances, undetermined whether accidentally or purposely inflicted due to drugs |
E980.0 |
Analgesics, antipyretics, and antirheumatics |
|
E980.1 |
Barbiturates |
|
|
E980.2 |
Other sedatives and hypnotics |
|
|
E980.3 |
Tranquilizers and other psychotropic agents |
|
|
E980.4 |
Other specified drugs and medicinal substances |
|
|
E980.5 |
Unspecified drug or medicinal substance |
|
|
Mental Health-Related Diagnoses |
Classification Codes in ICD-9-CM |
|---|---|
|
Adjustment disorders |
309.0, 309.1, 309.22, 309.23, 309.24, 309.28, 309.29, 309.3, 309.4 309.82, 309.83, 309.89, 309.9 |
|
Anxiety disorders |
293.84, 300.00–300.02, 300.09, 300.10, 300.20–300.23, 300.29, 300.3, 300.5, 300.89, 300.9, 308.0–308.4, 308.9, 309.81, 313.0, 313.1, 313.21, 313.22, 313.3, 313.82, 313.83 |
|
Mood disorders: |
|
|
Bipolar disorders |
296.00–296.06, 296.10–296.16, 296.40–296.46, 296.50–296.56, 296.60–296.66, 296.7, 296.80–296.82, 296.89, 296.90, 296.99 |
|
Depressive disorders |
293.83, 296.20–296.26, 296.30–296.36, 300.4, 311 |
|
Personality disorders |
301.0, 301.10–301.13, 301.20–301.22, 301.3, 301.4, 301.50, 301.51, 301.59, 301.6, 301.7, 301.81–301.84, 301.89, 301.9 |
|
Schizophrenia and other psychotic disorders |
293.81, 293.82, 295.00–295.05, 295.10–295.15, 295.20–295.25, 295.30–295.35, 295.40–295.45, 295.50–295.55, 295.60–295.65, 295.70–295.75, 295.80–295.85, 295.90–295.95, 297.0–297.3, 297.8, 297.9, 298.0–298.4, 298.8, 298.9 |
|
All other mental disorders: |
|
|
Attention deficit, and amnestic and other cognitive disorders |
312.00–312.03, 312.10–312.13, 312.20–312.23, 312.4, 312.8, 312.81, 312.82, 312.89, 312.9, 313.81, 314.00, 314.01, 314.1, 314.2, 314.8, 314.9 |
|
Disorders usually diagnosed in infancy, childhood, or adolescence |
299.00, 299.01, 299.10, 299.11, 299.80, 299.81, 299.90, 299.91, 307.20, 307.21–307.23, 307.3, 307.6, 307.7, 309.21, 313.23, 313.89, 313.9 |
|
Impulse control disorders, not elsewhere classified |
312.30–312.35, 312.39 |
|
Miscellaneous disorders, including eating disorders, mental disorders in pregnancy, dissociative disorders, factitious disorders, sleep disorders, and somatoform disorders |
293.89, 293.9 300.11–300.16, 300.19, 300.6, 300.7, 300.81, 300.82, 302.1–302.4, 302.50–302.53, 302.6, 302.70–302.76, 302.79, 302.81–302.85, 302.89, 302.9, 306.0–306.4, 306.50–306.53, 306.59, 306.6–306.9, 307.1, 307.40–307.49, 307.50–307.54, 307.59, 307.80, 307.81, 307.89, 310.1, 316, 648.40–648.44, V40.2, V40.3, V40.9, V67.3 |
|
Injury-Related Diagnoses |
Classification Codes in ICD-9-CM |
|---|---|
|
Note: The ICD-9-CM codes used in this manual to identify injuries are adopted from the CDC guideline (Thomas & Johnson, 2012), with a minor modification that E849 (place of injury occurrence) was excluded from the list. E849 is intended to provide supplemental information for other E-codes, including E-codes for injury and non-injury cases. Based on our analysis of the data, almost all cases that had E849 as the only E-code on record were related to complications/adverse effects of surgical and medical care procedures. Excluding E849 prevents incorrectly identifying non-injury cases as injury cases. |
|
|
Any injury-related diagnoses |
800–909.2, 909.4, 909.9, 910–994.9, 995.50–995.59, 995.80–995.85, E800–E848, E850–E869, E880–E929, E950–E999 |
|
Unintentional injuries |
E800–E848, E850–E869, E880–E929 |
|
Falls |
E880.0–E886.9, E888 |
|
Struck by or against objects or persons |
E916–E917.9 |
|
Motor vehicle traffic |
E810.0–E819.9 |
|
Cut or pierce |
E920.0–E920.9 |
|
Poisoning |
E850–E858, E859–E869 |
|
Intentional injuries |
E950–E959, E960–E969, E979, E999.1 |
4. Data Tables
Four sets of data tables (A, B, C, and D series) based on the NEDS and the NIS for ED visits and hospitalizations are provided in Chapter I and Chapter II, respectively. In each chapter, Tables A1–A10 present the percentage of events (i.e., ED visits or hospitalizations); Tables B1–B10 present the number of events; Tables C1–C10 present the rate of events in the population; and Tables D1-1 to D2-2 present the cost or charge of these events. In each table, data are shown for both sexes and all ages 12 and older combined, separately for males and females ages 12 and older, and separately for both sexes combined in each of five age categories (12–20, 21–24, 25–44, 45–64, and 65 and older). Because the same scheme is used to number the tables in the two chapters, the chapter number is indicated at the top outside corner on each page of the tables. This will help readers to easily tell whether a specific table refers to ED visits or hospitalizations.
It is important to note that the numbers presented in the data tables are estimates, because they are derived from a representative sample of hospitals and all the discharges within the sampled hospitals. In a sample, each visit/discharge represents one or more visits/discharges in the population to which the estimates apply. To enable readers to assess the precision of the estimates provided, each estimate is accompanied by a value for the standard error of the estimate (labeled S.E. in the tables). Multiplying the standard error by 1.96 provides a margin of error above and below each estimate. This range defines a 95-percent confidence interval that will have a 95-percent chance of including the true value being estimated. All standard errors in this manual were calculated using SUDAAN, as discussed earlier. Estimates with very large standard errors or based on very small samples can be extremely unreliable. Following the HCUP data suppression rule, estimates derived from 10 or fewer records are not reported. Tables cells suppressed under this rule are marked by a “–” symbol.
The following sections discuss the tables related to the major topics covered in the manual. Portions of selected tables are shown as examples on the following pages, in which certain numbers cited in the text are boldfaced for illustration purposes.
4.1. Alcohol-Related ED Visits and Hospitalizations
As described earlier, Exhibit 1 lists the specific medical conditions and their associated ICD-9-CM codes that comprise the alcohol-related diagnoses for defining alcohol-related ED visits and hospitalizations in this manual. These alcohol-related diagnoses include alcoholic psychoses; alcohol dependence syndrome; nondependent abuse of alcohol; chronic liver disease and cirrhosis, such as alcoholic liver disease; and alcohol poisoning. Relevant tables on this topic are Tables A1–A4, B1–B4, and C1–C4.
For example, Table A1 of Chapter I shows that 1.1276 percent of ED visits in 2010 for those ages 12 and older had a first-listed diagnosis of alcohol-related conditions. The percentage of males (1.8767) was about 3 times as high as that of females (0.5629). In addition, 0.5745 percent of the ED visits had a diagnosis of nondependent abuse of alcohol, a percentage that had increased from 0.4791 percent in 2006.
|
First-listed alcohol-related diagnoses by year |
Total | Sex | ||||
|---|---|---|---|---|---|---|
| Male | Female | |||||
| Percent | S.E. | Percent | S.E. | Percent | S.E. | |
|
SOURCE: Nationwide Emergency Department Sample, 2006–2010. |
||||||
|
Any alcohol-related diagnoses |
||||||
| 2010 | 1.1276 | 0.0366 | 1.8767 | 0.0656 | 0.5629 | 0.0151 |
| 2009 | 1.1017 | 0.0312 | 1.8296 | 0.0577 | 0.5535 | 0.0126 |
| 2008 | 1.0692 | 0.0349 | 1.7505 | 0.0633 | 0.5477 | 0.0140 |
| 2007 | 1.0275 | 0.0305 | 1.6658 | 0.0550 | 0.5323 | 0.0126 |
| 2006 | 0.9684 | 0.0270 | 1.5633 | 0.0481 | 0.5020 | 0.0114 |
|
Alcoholic psychoses |
||||||
| 2010 | 0.1696 | 0.0074 | 0.3003 | 0.0134 | 0.0710 | 0.0031 |
| 2009 | 0.1753 | 0.0081 | 0.3130 | 0.0147 | 0.0716 | 0.0035 |
| 2008 | 0.1588 | 0.0070 | 0.2789 | 0.0128 | 0.0669 | 0.0030 |
| 2007 | 0.1529 | 0.0083 | 0.2693 | 0.0154 | 0.0626 | 0.0030 |
| 2006 | 0.1406 | 0.0055 | 0.2447 | 0.0095 | 0.0590 | 0.0026 |
|
Alcohol dependence syndrome |
||||||
| 2010 | 0.2812 | 0.0153 | 0.4902 | 0.0283 | 0.1237 | 0.0058 |
| 2009 | 0.2697 | 0.0130 | 0.4653 | 0.0235 | 0.1225 | 0.0055 |
| 2008 | 0.2491 | 0.0133 | 0.4232 | 0.0238 | 0.1157 | 0.0058 |
| 2007 | 0.2444 | 0.0123 | 0.4126 | 0.0214 | 0.1138 | 0.0057 |
| 2006 | 0.2255 | 0.0106 | 0.3801 | 0.0191 | 0.1043 | 0.0045 |
|
Nondependent abuse of alcohol |
||||||
| 2010 | 0.5745 | 0.0257 | 0.9354 | 0.0462 | 0.3025 | 0.0106 |
| 2009 | 0.5486 | 0.0209 | 0.8925 | 0.0392 | 0.2894 | 0.0081 |
| 2008 | 0.5472 | 0.0219 | 0.8795 | 0.0396 | 0.2929 | 0.0088 |
| 2007 | 0.5132 | 0.0174 | 0.8128 | 0.0311 | 0.2808 | 0.0077 |
| 2006 | 0.4791 | 0.0183 | 0.7585 | 0.0337 | 0.2600 | 0.0072 |
| All-listed alcohol-related diagnoses by year | Total | Sex | ||||
|---|---|---|---|---|---|---|
| Male | Female | |||||
| Percent | S.E. | Percent | S.E. | Percent | S.E. | |
|
SOURCE: Nationwide Emergency Department Sample, 2006–2010. |
||||||
|
Any alcohol-related diagnoses |
||||||
| 2010 | 3.5591 | 0.0640 | 5.6673 | 0.1061 | 1.9699 | 0.0324 |
| 2009 | 3.3928 | 0.0603 | 5.4128 | 0.1026 | 1.8722 | 0.0302 |
| 2008 | 3.2974 | 0.0616 | 5.2249 | 0.1002 | 1.8211 | 0.0325 |
| 2007 | 3.1593 | 0.0605 | 4.9951 | 0.1011 | 1.7341 | 0.0305 |
| 2006 | 3.0447 | 0.0550 | 4.7977 | 0.0893 | 1.6705 | 0.0289 |
|
Alcoholic psychoses |
||||||
| 2010 | 0.3613 | 0.0114 | 0.6400 | 0.0204 | 0.1512 | 0.0049 |
| 2009 | 0.3701 | 0.0127 | 0.6568 | 0.0227 | 0.1543 | 0.0056 |
| 2008 | 0.3489 | 0.0117 | 0.6107 | 0.0200 | 0.1486 | 0.0058 |
| 2007 | 0.3329 | 0.0127 | 0.5828 | 0.0228 | 0.1391 | 0.0051 |
| 2006 | 0.3154 | 0.0093 | 0.5469 | 0.0157 | 0.1340 | 0.0044 |
|
Alcohol dependence syndrome |
||||||
| 2010 | 1.1591 | 0.0305 | 1.9857 | 0.0526 | 0.5359 | 0.0140 |
| 2009 | 1.1433 | 0.0289 | 1.9491 | 0.0502 | 0.5366 | 0.0138 |
| 2008 | 1.0819 | 0.0307 | 1.8287 | 0.0520 | 0.5103 | 0.0154 |
| 2007 | 1.0394 | 0.0327 | 1.7494 | 0.0567 | 0.4885 | 0.0150 |
| 2006 | 0.9704 | 0.0271 | 1.6216 | 0.0452 | 0.4599 | 0.0132 |
|
Nondependent abuse of alcohol |
||||||
| 2010 | 1.8390 | 0.0441 | 3.0084 | 0.0740 | 0.9574 | 0.0219 |
| 2009 | 1.7223 | 0.0401 | 2.8202 | 0.0693 | 0.8953 | 0.0190 |
| 2008 | 1.7197 | 0.0384 | 2.7948 | 0.0634 | 0.8958 | 0.0192 |
| 2007 | 1.6698 | 0.0367 | 2.6978 | 0.0614 | 0.8712 | 0.0183 |
| 2006 | 1.6551 | 0.0368 | 2.6637 | 0.0618 | 0.8644 | 0.0181 |
Table A2 of Chapter I shows that the percentage of ED visits with an all-listed diagnosis of alcohol-related conditions (3.5591) was about 3 times as high as that for first-listed (1.1276). While ED visits for all-listed alcohol psychoses (0.3613) was twice as high as that for first-listed (0.1696), all-listed alcohol dependence syndrome (1.1591) was about 4 times as high as that for first-listed (0.2812).
As shown in Table B2 of Chapter II, the number of hospitalizations among male patients ages 12 and older with a diagnosis of alcohol dependence syndrome increased from 625,651 in 2006 to 739,813 in 2010. The number of hospitalizations among female patients with a diagnosis of nondependent abuse of alcohol increased from 193,942 in 2006 to 220,499 in 2010.
The population rates corresponding to the numbers reported in Table B2 of Chapter II are shown in Table C2 of Chapter II. The rate of hospitalization for males ages 12 and older with a diagnosis of alcohol dependence syndrome increased from 51.1823 per 10,000 population in 2006 to 58.1953 per 10,000 population in 2010. The rate of hospitalizations for females with a diagnosis of nondependent abuse of alcohol increased from 15.1053 per 10,000 population in 2006 to 16.5391 per 10,000 population in 2010.
| All-listed alcohol-related diagnoses by year | Total | Sex | ||||
|---|---|---|---|---|---|---|
| Male | Female | |||||
| Number | S.E. | Number | S.E. | Number | S.E. | |
|
SOURCE: Nationwide Inpatient Sample, 2006–2010. |
||||||
|
Alcohol dependence syndrome |
||||||
| 2010 | 1,013,634 | 40,892 | 739,813 | 31,856 | 273,614 | 10,629 |
| 2009 | 968,922 | 39,678 | 707,382 | 30,919 | 261,352 | 10,084 |
| 2008 | 919,020 | 40,200 | 660,481 | 30,130 | 258,266 | 11,425 |
| 2007 | 865,866 | 32,988 | 628,827 | 25,703 | 236,513 | 8,670 |
| 2006 | 855,480 | 38,351 | 625,651 | 29,891 | 229,477 | 9,378 |
|
Nondependent abuse of alcohol |
||||||
| 2010 | 774,177 | 28,020 | 553,207 | 20,947 | 220,499 | 7,551 |
| 2009 | 701,914 | 25,176 | 500,419 | 18,748 | 201,038 | 6,888 |
| 2008 | 660,381 | 24,345 | 467,762 | 17,630 | 192,277 | 7,230 |
| 2007 | 686,721 | 26,283 | 488,959 | 20,082 | 197,302 | 6,801 |
| 2006 | 700,593 | 27,648 | 506,342 | 21,067 | 193,942 | 7,160 |
|
All chronic liver disease and cirrhosis |
||||||
| 2010 | 852,354 | 24,173 | 497,794 | 14,920 | 354,505 | 9,929 |
| 2009 | 796,890 | 23,307 | 465,795 | 13,753 | 331,003 | 10,069 |
| 2008 | 731,913 | 22,756 | 428,432 | 13,839 | 303,380 | 9,369 |
| 2007 | 660,920 | 17,516 | 392,988 | 11,446 | 267,789 | 6,627 |
| 2006 | 633,730 | 17,320 | 377,263 | 11,068 | 256,381 | 6,840 |
|
Alcohol poisoning |
||||||
| 2010 | 29,822 | 1,665 | 16,400 | 1,082 | 13,423 | 669 |
| 2009 | 27,349 | 1,213 | 14,594 | 700 | 12,750 | 605 |
| 2008 | 29,430 | 1,353 | 15,876 | 799 | 13,553 | 661 |
| 2007 | 24,825 | 1,158 | 13,078 | 611 | 11,706 | 627 |
| 2006 | 25,322 | 1,214 | 13,770 | 744 | 11,548 | 570 |
| All-listed alcohol-related diagnoses by year | Total | Sex | ||||
|---|---|---|---|---|---|---|
| Male | Female | |||||
| Rate | S.E. | Rate | S.E. | Rate | S.E. | |
|
SOURCE: Nationwide Inpatient Sample, 2006–2010. |
||||||
|
Alcohol dependence syndrome |
||||||
| 2010 | 38.9193 | 1.5701 | 58.1953 | 2.5058 | 20.5232 | 0.7973 |
| 2009 | 37.5341 | 1.5370 | 56.1576 | 2.4546 | 19.7723 | 0.7629 |
| 2008 | 35.9351 | 1.5719 | 52.9295 | 2.4145 | 19.7212 | 0.8724 |
| 2007 | 34.1958 | 1.3028 | 50.9085 | 2.0809 | 18.2372 | 0.6685 |
| 2006 | 34.1327 | 1.5301 | 51.1823 | 2.4453 | 17.8729 | 0.7304 |
|
Nondependent abuse of alcohol |
||||||
| 2010 | 29.7252 | 1.0759 | 43.5165 | 1.6478 | 16.5391 | 0.5664 |
| 2009 | 27.1907 | 0.9753 | 39.7273 | 1.4884 | 15.2093 | 0.5211 |
| 2008 | 25.8219 | 0.9519 | 37.4854 | 1.4128 | 14.6822 | 0.5521 |
| 2007 | 27.1208 | 1.0380 | 39.5851 | 1.6258 | 15.2136 | 0.5244 |
| 2006 | 27.9529 | 1.1031 | 41.4221 | 1.7234 | 15.1053 | 0.5576 |
|
All chronic liver disease and cirrhosis |
||||||
| 2010 | 32.7268 | 0.9281 | 39.1576 | 1.1736 | 26.5906 | 0.7448 |
| 2009 | 30.8699 | 0.9029 | 36.9785 | 1.0918 | 25.0416 | 0.7617 |
| 2008 | 28.6190 | 0.8898 | 34.3336 | 1.1090 | 23.1660 | 0.7154 |
| 2007 | 26.1018 | 0.6917 | 31.8155 | 0.9266 | 20.6488 | 0.5110 |
| 2006 | 25.2852 | 0.6910 | 30.8626 | 0.9055 | 19.9684 | 0.5328 |
|
Alcohol poisoning |
||||||
| 2010 | 1.1451 | 0.0639 | 1.2900 | 0.0851 | 1.0068 | 0.0502 |
| 2009 | 1.0594 | 0.0470 | 1.1586 | 0.0556 | 0.9646 | 0.0458 |
| 2008 | 1.1507 | 0.0529 | 1.2723 | 0.0640 | 1.0349 | 0.0505 |
| 2007 | 0.9804 | 0.0457 | 1.0588 | 0.0495 | 0.9027 | 0.0484 |
| 2006 | 1.0103 | 0.0484 | 1.1264 | 0.0608 | 0.8994 | 0.0444 |
4.2. Co-occurrence of Alcohol-Related and Drug-Related ED Visits and Hospitalizations
Exhibit 2 lists the specific medical conditions and their associated ICD-9-CM codes that comprise the co-occurring drug-related diagnoses for alcohol-related ED visits and hospitalizations in this manual. These co-occurring drug-related diagnoses include drug psychoses, drug dependence, nondependent abuse of drugs, and poisoning by drugs and medicinal and biological substances. Relevant tables on this topic are Tables A5–A6, B5–B6, and C5–C6 in both chapters.
For example, Table A5 of Chapter I shows that among ED visits by patients ages 12–20 with a first-listed diagnosis of alcohol-related conditions in 2009, 10.4149 percent also had a drug-related diagnosis. The percentage increased in the 21–24 age group (11.7141) and the 25–44 age group (13.7157), then dropped in the 45–64 age group (9.2758) and was lowest (2.8101) in the 65+ age group.
| First-listed alcohol-related diagnoses by co-occurring drug-related diagnoses and year |
Age group | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 12–20 years | 21–24 years | 25–44 years | 45–64 years | 65+ years | ||||||
| Percent | S.E. | Percent | S.E. | Percent | S.E. | Percent | S.E. | Percent | S.E. | |
|
SOURCE: Nationwide Emergency Department Sample, 2006–2010. |
||||||||||
|
Any alcohol-related diagnoses |
||||||||||
|
Any drug-related diagnoses |
||||||||||
| 2010 | 10.5599 | 0.4219 | 11.1513 | 0.4497 | 12.9930 | 0.4796 | 8.9504 | 0.4104 | 2.9796 | 0.1903 |
| 2009 | 10.4149 | 0.4110 | 11.7141 | 0.4572 | 13.7157 | 0.4964 | 9.2758 | 0.3398 | 2.8101 | 0.1973 |
| 2008 | 11.5120 | 0.4542 | 11.6685 | 0.5534 | 13.8112 | 0.5388 | 9.0148 | 0.3147 | 2.7641 | 0.1972 |
| 2007 | 11.3011 | 0.4901 | 12.3541 | 0.5488 | 15.1027 | 0.7752 | 9.4118 | 0.4104 | 2.5223 | 0.1728 |
| 2006 | 11.0244 | 0.3706 | 12.8177 | 0.5033 | 14.0358 | 0.3996 | 8.2116 | 0.2387 | 1.8994 | 0.1338 |
|
Drug psychoses |
||||||||||
| 2010 | 0.2028 | 0.0376 | 0.5814 | 0.0782 | 1.0272 | 0.0760 | 0.8031 | 0.0561 | 0.4134 | 0.0540 |
| 2009 | 0.3198 | 0.0420 | 0.9691 | 0.1191 | 1.1103 | 0.0865 | 0.8716 | 0.0564 | 0.4617 | 0.1084 |
| 2008 | 0.2725 | 0.0455 | 0.6934 | 0.1006 | 1.0218 | 0.0971 | 0.8519 | 0.0697 | 0.5469 | 0.1122 |
| 2007 | 0.2793 | 0.0493 | 0.4792 | 0.0731 | 1.1079 | 0.1461 | 0.8046 | 0.0791 | 0.4145 | 0.0673 |
| 2006 | 0.2524 | 0.0396 | 0.4898 | 0.0632 | 0.9461 | 0.0908 | 0.7031 | 0.0471 | 0.3167 | 0.0539 |
|
Drug dependence |
||||||||||
| 2010 | 0.6147 | 0.0743 | 1.5440 | 0.1532 | 3.0271 | 0.3357 | 2.4929 | 0.3389 | 0.8933 | 0.1186 |
| 2009 | 0.6473 | 0.0796 | 1.9478 | 0.1834 | 3.5266 | 0.3228 | 2.6302 | 0.2209 | 0.7518 | 0.1272 |
| 2008 | 0.8890 | 0.1582 | 1.7710 | 0.2155 | 3.4651 | 0.4248 | 2.5073 | 0.2763 | 0.6742 | 0.0812 |
| 2007 | 0.9954 | 0.1955 | 1.6613 | 0.1996 | 4.1473 | 0.7179 | 2.6390 | 0.3890 | 0.6474 | 0.1044 |
| 2006 | 0.5907 | 0.0695 | 1.5715 | 0.1590 | 2.8421 | 0.2019 | 1.7897 | 0.1136 | 0.4796 | 0.0648 |
| All-listed alcohol-related diagnoses by co-occurring drug-related diagnoses and year | Age group | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 12–20 years | 21–24 years | 25–44 years | 45–64 years | 65+ years | ||||||
| Rate | S.E. | Rate | S.E. | Rate | S.E. | Rate | S.E. | Rate | S.E. | |
|
— Less than or equal to 10 observations in the cell. SOURCE: Nationwide Inpatient Sample, 2006–2010. |
||||||||||
|
Alcohol poisoning |
||||||||||
|
Drug dependence |
||||||||||
| 2010 | 0.0261 | 0.0060 | 0.0823 | 0.0160 | 0.1164 | 0.0122 | 0.1041 | 0.0187 | — | — |
| 2009 | 0.0344 | 0.0077 | 0.0917 | 0.0177 | 0.1283 | 0.0140 | 0.0899 | 0.0126 | — | — |
| 2008 | 0.0341 | 0.0075 | 0.0740 | 0.0169 | 0.1193 | 0.0116 | 0.1046 | 0.0108 | — | — |
| 2007 | 0.0236 | 0.0059 | 0.0976 | 0.0183 | 0.0978 | 0.0100 | 0.0624 | 0.0071 | — | — |
| 2006 | 0.0204 | 0.0050 | 0.0729 | 0.0188 | 0.1239 | 0.0142 | 0.0683 | 0.0085 | — | — |
|
Nondependent abuse of drugs |
||||||||||
| 2010 | 0.1286 | 0.0155 | 0.3691 | 0.0382 | 0.3489 | 0.0266 | 0.2711 | 0.0272 | 0.0208 | 0.0051 |
| 2009 | 0.1642 | 0.0169 | 0.3578 | 0.0356 | 0.3435 | 0.0223 | 0.2109 | 0.0163 | 0.0244 | 0.0059 |
| 2008 | 0.1613 | 0.0164 | 0.3379 | 0.0368 | 0.3636 | 0.0246 | 0.2254 | 0.0181 | — | — |
| 2007 | 0.1357 | 0.0165 | 0.3304 | 0.0368 | 0.3475 | 0.0267 | 0.1832 | 0.0160 | 0.0167 | 0.0059 |
| 2006 | 0.1665 | 0.0192 | 0.3255 | 0.0366 | 0.3216 | 0.0216 | 0.1742 | 0.0140 | 0.0188 | 0.0065 |
|
Drug poisoning |
||||||||||
| 2010 | 0.3063 | 0.0256 | 0.9157 | 0.0673 | 1.1070 | 0.0564 | 0.8803 | 0.0446 | 0.1575 | 0.0168 |
| 2009 | 0.3239 | 0.0265 | 0.9448 | 0.0670 | 1.0884 | 0.0536 | 0.8350 | 0.0429 | 0.1625 | 0.0160 |
| 2008 | 0.3785 | 0.0292 | 1.0508 | 0.0764 | 1.2283 | 0.0632 | 0.9222 | 0.0504 | 0.1558 | 0.0153 |
| 2007 | 0.2941 | 0.0265 | 0.8655 | 0.0608 | 1.0441 | 0.0595 | 0.7257 | 0.0429 | 0.1636 | 0.0166 |
| 2006 | 0.3545 | 0.0281 | 0.9346 | 0.0699 | 1.0963 | 0.0605 | 0.7247 | 0.0398 | 0.1292 | 0.0147 |
Table C6 of Chapter II shows that in 2010, the rate of hospitalizations for patients ages 25 to 44 diagnosed with alcohol poisoning and a co-occurring drug poisoning was 1.1070 per 10,000 population. The exact number of these hospitalizations used as the numerator of this rate can be found in Table B6 of Chapter II, which shows that 9,102 hospitalizations in 2010 were among this group of inpatients. Note that in Tables B6 and C6, some of the values for the 65+ age group are suppressed and marked with a “–” symbol, because these cells had 10 or fewer patient records in the samples.
| All-listed alcohol-related diagnoses by co-occurring drug-related diagnoses and year |
Age group | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 12–20 years | 21–24 years | 25–44 years | 45–64 years | 65+ years | ||||||
| Number | S.E. | Number | S.E. | Number | S.E. | Number | S.E. | Number | S.E. | |
|
— Less than or equal to 10 observations in the cell. SOURCE: Nationwide Inpatient Sample, 2006–2010. |
||||||||||
|
Alcohol poisoning |
||||||||||
|
Drug dependence |
||||||||||
| 2010 | 102 | 23 | 141 | 27 | 957 | 100 | 851 | 153 | — | — |
| 2009 | 134 | 30 | 156 | 30 | 1,054 | 115 | 722 | 101 | — | — |
| 2008 | 133 | 29 | 125 | 28 | 983 | 96 | 823 | 85 | — | — |
| 2007 | 92 | 23 | 164 | 31 | 807 | 83 | 481 | 55 | — | — |
| 2006 | 79 | 19 | 122 | 32 | 1,024 | 117 | 513 | 64 | — | — |
|
Nondependent abuse of drugs |
||||||||||
| 2010 | 500 | 60 | 632 | 65 | 2,869 | 219 | 2,217 | 222 | 84 | 21 |
| 2009 | 641 | 66 | 608 | 61 | 2,824 | 183 | 1,693 | 131 | 97 | 23 |
| 2008 | 630 | 64 | 570 | 62 | 2,996 | 202 | 1,772 | 142 | — | — |
| 2007 | 529 | 64 | 556 | 62 | 2,867 | 220 | 1,412 | 124 | 63 | 22 |
| 2006 | 646 | 74 | 546 | 61 | 2,658 | 178 | 1,310 | 106 | 70 | 24 |
|
Drug poisoning |
||||||||||
| 2010 | 1,191 | 100 | 1,567 | 115 | 9,102 | 464 | 7,199 | 365 | 637 | 68 |
| 2009 | 1,265 | 104 | 1,606 | 114 | 8,948 | 441 | 6,703 | 344 | 644 | 63 |
| 2008 | 1,479 | 114 | 1,773 | 129 | 10,121 | 521 | 7,250 | 396 | 604 | 59 |
| 2007 | 1,146 | 103 | 1,457 | 102 | 8,615 | 491 | 5,593 | 331 | 619 | 63 |
| 2006 | 1,376 | 109 | 1,569 | 117 | 9,060 | 500 | 5,451 | 299 | 480 | 55 |
4.3. Co-occurrence of Alcohol-Related and Mental Health-Related ED Visits and Hospitalizations
Exhibit 3 lists the specific medical conditions and their associated ICD-9-CM codes that comprise the co-occurring mental health-related diagnoses for alcohol-related ED visits and hospitalizations in this manual. These co-occurring mental health-related diagnoses include adjustment disorders, anxiety disorders, mood disorders, personality disorders, schizophrenia and other psychotic disorders, and all other mental disorders. Relevant tables on this topic are Tables A7–A8, B7–B8, and C7–C8.
Table A8 of Chapter II shows that in 2010, among hospitalizations of patients ages 12 and older, 46.6544 percent of those with an all-listed diagnosis of alcohol dependence syndrome also had a co-occurring mental health-related diagnosis. Notably, the percentage has increased from 41.3193 in 2006, and it was higher for females (60.4148 in 2010) than for males (41.5631 in 2010). Table B8 of Chapter II shows that in 2010, there were 307,489 hospitalizations of male patients ages 12 and older who had any alcohol dependence syndrome and any co-occurring mental health condition. The corresponding number for females was only 165,303.
| All-listed alcohol-related diagnoses by co-occurring mental health-related diagnoses and year |
Total | Sex | ||||
|---|---|---|---|---|---|---|
| Male | Female | |||||
| Percent | S.E. | Percent | S.E. | Percent | S.E. | |
|
SOURCE: Nationwide Inpatient Sample, 2006–2010. |
||||||
|
Alcohol dependence syndrome |
||||||
|
Any mental health-related diagnoses |
||||||
| 2010 | 46.6544 | 0.8947 | 41.5631 | 0.8652 | 60.4148 | 0.8622 |
| 2009 | 46.3867 | 0.9253 | 41.1334 | 0.9010 | 60.6138 | 0.8710 |
| 2008 | 46.5773 | 1.1603 | 41.2822 | 1.1281 | 60.1322 | 1.0919 |
| 2007 | 42.5940 | 0.8667 | 37.4338 | 0.8256 | 56.3621 | 0.9034 |
| 2006 | 41.3193 | 1.0071 | 36.4255 | 0.9643 | 54.6981 | 1.0109 |
|
Anxiety disorder |
||||||
| 2010 | 10.9845 | 0.4003 | 9.0305 | 0.3348 | 16.2743 | 0.5439 |
| 2009 | 10.8263 | 0.4141 | 8.7645 | 0.3597 | 16.4127 | 0.5570 |
| 2008 | 10.0776 | 0.4454 | 8.2431 | 0.3773 | 14.7799 | 0.5990 |
| 2007 | 8.8600 | 0.3386 | 7.1467 | 0.2851 | 13.4314 | 0.4843 |
| 2006 | 7.9802 | 0.3401 | 6.5430 | 0.2798 | 11.9108 | 0.5075 |
|
Depressive disorder |
||||||
| 2010 | 25.2395 | 0.6450 | 22.0132 | 0.6173 | 33.9460 | 0.6538 |
| 2009 | 25.1998 | 0.6209 | 21.8199 | 0.6014 | 34.3562 | 0.6007 |
| 2008 | 25.2779 | 0.7726 | 21.8725 | 0.7210 | 33.9925 | 0.8402 |
| 2007 | 23.4403 | 0.5695 | 20.1554 | 0.5302 | 32.1994 | 0.6417 |
| 2006 | 22.3070 | 0.6762 | 19.0272 | 0.6238 | 31.2664 | 0.7349 |
| All-listed alcohol-related diagnoses by co-occurring mental health-related diagnoses and year |
Total | Sex | ||||
|---|---|---|---|---|---|---|
| Male | Female | |||||
| Number | S.E. | Number | S.E. | Number | S.E. | |
|
SOURCE: Nationwide Inpatient Sample, 2006–2010. |
||||||
|
Alcohol dependence syndrome |
||||||
|
Any mental health-related diagnoses |
||||||
| 2010 | 472,905 | 21,744 | 307,489 | 14,751 | 165,303 | 7,582 |
| 2009 | 449,451 | 20,298 | 290,971 | 13,596 | 158,415 | 7,184 |
| 2008 | 428,055 | 22,648 | 272,661 | 14,225 | 155,301 | 8,782 |
| 2007 | 368,807 | 17,009 | 235,394 | 11,438 | 133,304 | 6,041 |
| 2006 | 353,478 | 18,050 | 227,896 | 12,150 | 125,519 | 6,219 |
|
Anxiety disorder |
||||||
| 2010 | 111,342 | 5,496 | 66,809 | 3,209 | 44,529 | 2,429 |
| 2009 | 104,898 | 5,632 | 61,999 | 3,336 | 42,895 | 2,451 |
| 2008 | 92,616 | 5,649 | 54,444 | 3,136 | 38,172 | 2,639 |
| 2007 | 76,716 | 3,835 | 44,940 | 2,224 | 31,767 | 1,757 |
| 2006 | 68,269 | 3,780 | 40,936 | 2,273 | 27,333 | 1,639 |
|
Depressive disorder |
||||||
| 2010 | 255,836 | 11,348 | 162,857 | 7,451 | 92,881 | 4,177 |
| 2009 | 244,167 | 10,777 | 154,350 | 6,875 | 89,791 | 4,124 |
| 2008 | 232,309 | 12,623 | 144,464 | 7,613 | 87,791 | 5,263 |
| 2007 | 202,962 | 9,120 | 126,742 | 5,934 | 76,156 | 3,454 |
| 2006 | 190,831 | 9,266 | 119,044 | 5,901 | 71,749 | 3,532 |
Table C8 of Chapter II similarly shows that the corresponding rate for males was higher than that for females (24.1878 per 10,000 population versus 12.3990 per 10,000 population). Although Table A8 of Chapter II suggests that the co-occurrence of mental health conditions was more prevalent among females diagnosed with alcohol dependence syndrome than among their male counterparts, Tables B8 and C8 show a smaller number and a lower rate for females than for males. This was largely because fewer females (273,614) than males (739,813) were hospitalized for alcohol dependence syndrome, as shown in Table B2 of Chapter II.
| All-listed alcohol-related diagnoses by co-occurring mental health-related diagnoses and year |
Total | Sex | ||||
|---|---|---|---|---|---|---|
| Male | Female | |||||
| Rate | S.E. | Rate | S.E. | Rate | S.E. | |
|
SOURCE: Nationwide Inpatient Sample, 2006–2010. |
||||||
|
Alcohol dependence syndrome |
||||||
|
Any mental health-related diagnoses |
||||||
| 2010 | 18.1576 | 0.8349 | 24.1878 | 1.1603 | 12.3990 | 0.5687 |
| 2009 | 17.4108 | 0.7863 | 23.0996 | 1.0794 | 11.9847 | 0.5435 |
| 2008 | 16.7376 | 0.8856 | 21.8505 | 1.1400 | 11.8588 | 0.6706 |
| 2007 | 14.5654 | 0.6717 | 19.0570 | 0.9260 | 10.2789 | 0.4658 |
| 2006 | 14.1034 | 0.7202 | 18.6434 | 0.9940 | 9.7761 | 0.4844 |
|
Anxiety disorder |
||||||
| 2010 | 4.2751 | 0.2110 | 5.2553 | 0.2524 | 3.3400 | 0.1822 |
| 2009 | 4.0635 | 0.2182 | 4.9220 | 0.2648 | 3.2452 | 0.1854 |
| 2008 | 3.6214 | 0.2209 | 4.3630 | 0.2513 | 2.9148 | 0.2015 |
| 2007 | 3.0298 | 0.1515 | 3.6383 | 0.1800 | 2.4495 | 0.1355 |
| 2006 | 2.7239 | 0.1508 | 3.3489 | 0.1859 | 2.1288 | 0.1276 |
|
Depressive disorder |
||||||
| 2010 | 9.8230 | 0.4357 | 12.8107 | 0.5861 | 6.9668 | 0.3133 |
| 2009 | 9.4585 | 0.4175 | 12.2535 | 0.5458 | 6.7930 | 0.3120 |
| 2008 | 9.0837 | 0.4936 | 11.5770 | 0.6101 | 6.7037 | 0.4019 |
| 2007 | 8.0156 | 0.3602 | 10.2608 | 0.4804 | 5.8723 | 0.2663 |
| 2006 | 7.6140 | 0.3697 | 9.7386 | 0.4827 | 5.5882 | 0.2751 |
4.4. Co-occurrence of Alcohol-Related and Injury-Related ED Visits and Hospitalizations
Exhibit 4 lists the specific medical conditions and their associated ICD-9-CM codes that comprise the co-occurring injury-related diagnoses for alcohol-related ED visits and hospitalizations in this manual. These co-occurring injury-related diagnoses include unintentional injuries (such as falling, being struck by or against objects or persons, motor vehicle traffic, being cut or pierced, and being poisoned) and intentional injuries. Relevant tables on this topic are Tables A9–A10, B9–B10, and C9–C10 in both chapters. Portions of the selected tables are shown below as examples, in which certain numbers are boldfaced for illustration purposes.
For example, Table A10 of Chapter I shows that in 2010, among ED visits by patients ages 12–20, 28.9635 percent of those with an all-listed diagnosis of nondependent abuse of alcohol also had any injury-related diagnosis. The percentage increased in the 21–24 age group (38.7219), then dropped in the 25–44 and 45–64 age groups (30.3525 and 23.4314, respectively) and increased slightly in the 65+ age group (26.3012). Notably, the percentages of co-occurring injuries declined significantly between 2006 and 2010 for the two youngest groups (12–20 and 21–24) but remained almost unchanged for the older age groups.
In 2010, unintentional fall injury that co-occurred with nondependent abuse of alcohol among ED visits was most prevalent in the 65+ age group (18.3112 percent) and least prevalent in the 21–24 age group (5.0222 percent). By contrast, the co-occurring motor vehicle traffic injury was least prevalent in the 65+ age group (1.3144 percent) and most prevalent in the 21–24 age group (7.3974 percent), although the prevalence in the latter age group had decreased from 10.7162 percent in 2006.
| All-listed alcohol-related diagnoses by co-occurring injury-related diagnoses and year |
Age group | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 12–20 years | 21–24 years | 25–44 years | 45–64 years | 65+ years | ||||||
| Percent | S.E. | Percent | S.E. | Percent | S.E. | Percent | S.E. | Percent | S.E. | |
|
SOURCE: Nationwide Emergency Department Sample, 2006–2010. |
||||||||||
|
Nondependent abuse of alcohol |
||||||||||
|
Any injury-related diagnoses |
||||||||||
| 2010 | 28.9635 | 0.6097 | 38.7219 | 0.6426 | 30.3525 | 0.5083 | 23.4314 | 0.4390 | 26.3012 | 0.4173 |
| 2009 | 29.7761 | 0.5628 | 41.0545 | 0.6735 | 31.3989 | 0.5331 | 23.7447 | 0.4149 | 26.3597 | 0.4130 |
| 2008 | 30.5641 | 0.6163 | 41.5644 | 0.7319 | 32.4790 | 0.5735 | 24.1788 | 0.4161 | 26.7597 | 0.4662 |
| 2007 | 30.4140 | 0.6129 | 42.6934 | 0.6531 | 32.1494 | 0.5284 | 23.9188 | 0.3806 | 25.9390 | 0.4383 |
| 2006 | 32.7560 | 0.6001 | 44.5662 | 0.6746 | 31.6111 | 0.5913 | 23.5468 | 0.4247 | 26.0200 | 0.4452 |
|
Unintentional Injuries |
||||||||||
| 2010 | 16.9575 | 0.4421 | 22.6701 | 0.5475 | 17.5930 | 0.3778 | 16.6448 | 0.3483 | 23.2976 | 0.4390 |
| 2009 | 16.9693 | 0.3980 | 23.8687 | 0.5590 | 17.9323 | 0.3795 | 16.6121 | 0.3218 | 23.2402 | 0.4169 |
| 2008 | 17.2035 | 0.4009 | 23.8847 | 0.5468 | 18.2744 | 0.3788 | 16.5421 | 0.3042 | 23.3224 | 0.4484 |
| 2007 | 17.4857 | 0.4909 | 24.8362 | 0.5908 | 17.9595 | 0.4255 | 16.0924 | 0.3654 | 22.2461 | 0.5038 |
| 2006 | 19.0759 | 0.4843 | 25.0840 | 0.5469 | 17.8484 | 0.3948 | 16.1161 | 0.3477 | 22.3990 | 0.4720 |
|
Falls |
||||||||||
| 2010 | 5.0222 | 0.2042 | 6.8799 | 0.2073 | 6.0455 | 0.1339 | 9.0020 | 0.1845 | 18.3112 | 0.3711 |
| 2009 | 4.6174 | 0.1773 | 6.4886 | 0.2380 | 6.0311 | 0.1290 | 8.9033 | 0.1803 | 18.2889 | 0.3717 |
| 2008 | 4.5084 | 0.1802 | 6.5663 | 0.2412 | 5.6983 | 0.1210 | 8.5477 | 0.1620 | 18.2265 | 0.3776 |
| 2007 | 4.1950 | 0.1533 | 6.2412 | 0.2316 | 5.4252 | 0.1481 | 8.2080 | 0.1987 | 17.2390 | 0.4361 |
| 2006 | 4.4599 | 0.2157 | 5.9898 | 0.1984 | 5.3912 | 0.1493 | 8.2498 | 0.1947 | 17.5324 | 0.4145 |
|
Motor vehicle traffic |
||||||||||
| 2010 | 4.9098 | 0.2369 | 7.3974 | 0.3423 | 4.5269 | 0.1879 | 2.1827 | 0.1037 | 1.3144 | 0.0935 |
| 2009 | 5.3253 | 0.2747 | 8.8442 | 0.4015 | 4.9741 | 0.2031 | 2.3859 | 0.1003 | 1.2216 | 0.0795 |
| 2008 | 5.7237 | 0.2360 | 8.8879 | 0.3677 | 5.5914 | 0.2096 | 2.6456 | 0.0953 | 1.4851 | 0.0801 |
| 2007 | 6.4302 | 0.2831 | 10.1499 | 0.4045 | 5.6323 | 0.2014 | 2.7217 | 0.1060 | 1.4601 | 0.0976 |
| 2006 | 7.5148 | 0.3181 | 10.7162 | 0.4165 | 5.6272 | 0.2214 | 2.7406 | 0.1080 | 1.4324 | 0.0966 |
Table C10 of Chapter I shows that in 2010, the population rate of ED visits by patients ages 21 to 24 who were diagnosed with any nondependent abuse of alcohol and co-occurring unintentional motor vehicle traffic injury was 6.8205 per 10,000 population, a decrease from 8.2799 per 10,000 population in 2006. The exact number of hospital discharges used as the numerator of this rate can be found in Table B10 of Chapter I, which shows that 11,671 ED visits in 2010 and 13,900 ED visits in 2006 were made by those ages 21 to 24 diagnosed with nondependent abuse of alcohol and co-occurring motor vehicle traffic injury.
| All-listed alcohol-related diagnoses by co-occurring injury-related diagnoses and year | Age group | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 12–20 years | 21–24 years | 25–44 years | 45–64 years | 65+ years | ||||||
| Rate | S.E. | Rate | S.E. | Rate | S.E. | Rate | S.E. | Rate | S.E. | |
|
SOURCE: Nationwide Emergency Department Sample, 2006–2010. |
||||||||||
|
Nondependent abuse of alcohol |
||||||||||
|
Any injury-related diagnoses |
||||||||||
| 2010 | 11.8894 | 0.4146 | 35.7022 | 1.2730 | 26.5042 | 0.8649 | 24.1977 | 0.7907 | 9.9134 | 0.3206 |
| 2009 | 11.9091 | 0.4300 | 35.7312 | 1.3983 | 25.7423 | 0.8743 | 22.1173 | 0.7480 | 9.2248 | 0.2827 |
| 2008 | 12.4306 | 0.5021 | 36.6091 | 1.5022 | 26.5899 | 0.9043 | 21.5722 | 0.7160 | 9.5195 | 0.3125 |
| 2007 | 12.1563 | 0.4474 | 35.1461 | 1.3123 | 25.3595 | 0.8739 | 19.9527 | 0.6396 | 8.9272 | 0.2946 |
| 2006 | 12.3883 | 0.4074 | 34.4340 | 1.1726 | 24.5317 | 0.7465 | 19.6269 | 0.6058 | 9.0737 | 0.2840 |
|
Unintentional Injuries |
||||||||||
| 2010 | 6.9609 | 0.2596 | 20.9022 | 0.8075 | 15.3624 | 0.5313 | 17.1892 | 0.5880 | 8.7813 | 0.2962 |
| 2009 | 6.7869 | 0.2620 | 20.7738 | 0.8973 | 14.7018 | 0.5258 | 15.4735 | 0.5291 | 8.1331 | 0.2579 |
| 2008 | 6.9968 | 0.2858 | 21.0372 | 0.9042 | 14.9609 | 0.5038 | 14.7587 | 0.4856 | 8.2968 | 0.2766 |
| 2007 | 6.9890 | 0.2719 | 20.4457 | 0.8477 | 14.1665 | 0.5202 | 13.4241 | 0.4385 | 7.6563 | 0.2645 |
| 2006 | 7.2145 | 0.2710 | 19.3811 | 0.7355 | 13.8512 | 0.4391 | 13.4332 | 0.4354 | 7.8110 | 0.2583 |
|
Falls |
||||||||||
| 2010 | 2.0616 | 0.1051 | 6.3434 | 0.2736 | 5.2790 | 0.1910 | 9.2964 | 0.3215 | 6.9018 | 0.2402 |
| 2009 | 1.8468 | 0.1011 | 5.6473 | 0.3051 | 4.9446 | 0.1832 | 8.2930 | 0.2897 | 6.4003 | 0.2142 |
| 2008 | 1.8336 | 0.1023 | 5.7835 | 0.3248 | 4.6651 | 0.1658 | 7.6262 | 0.2551 | 6.4839 | 0.2226 |
| 2007 | 1.6767 | 0.0796 | 5.1379 | 0.2736 | 4.2794 | 0.1654 | 6.8470 | 0.2348 | 5.9330 | 0.2200 |
| 2006 | 1.6867 | 0.1006 | 4.6280 | 0.2131 | 4.1838 | 0.1532 | 6.8764 | 0.2455 | 6.1139 | 0.2103 |
|
Motor vehicle traffic |
||||||||||
| 2010 | 2.0155 | 0.1062 | 6.8205 | 0.3681 | 3.9530 | 0.1814 | 2.2541 | 0.1136 | 0.4954 | 0.0361 |
| 2009 | 2.1299 | 0.1175 | 7.6974 | 0.4243 | 4.0780 | 0.1951 | 2.2224 | 0.1068 | 0.4275 | 0.0287 |
| 2008 | 2.3279 | 0.1150 | 7.8283 | 0.4203 | 4.5776 | 0.1972 | 2.3604 | 0.0986 | 0.5283 | 0.0317 |
| 2007 | 2.5701 | 0.1226 | 8.3556 | 0.4089 | 4.4428 | 0.1912 | 2.2704 | 0.0961 | 0.5025 | 0.0342 |
| 2006 | 2.8421 | 0.1353 | 8.2799 | 0.3972 | 4.3670 | 0.1827 | 2.2843 | 0.0894 | 0.4995 | 0.0340 |
| All-listed alcohol-related diagnoses by co-occurring injury-related diagnoses and year | Age group | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 12–20 years | 21–24 years | 25–44 years | 45–64 years | 65+ years | ||||||
| Number | S.E. | Number | S.E. | Number | S.E. | Number | S.E. | Number | S.E. | |
|
SOURCE: Nationwide Emergency Department Sample, 2006–2010. |
||||||||||
|
Nondependent abuse of alcohol |
||||||||||
|
Any injury-related diagnoses |
||||||||||
| 2010 | 46,236 | 1,612 | 61,091 | 2,178 | 217,940 | 7,112 | 197,888 | 6,467 | 40,087 | 1,296 |
| 2009 | 46,490 | 1,679 | 60,745 | 2,377 | 211,630 | 7,188 | 177,541 | 6,005 | 36,552 | 1,120 |
| 2008 | 48,568 | 1,962 | 61,787 | 2,535 | 219,101 | 7,451 | 169,595 | 5,629 | 36,915 | 1,212 |
| 2007 | 47,372 | 1,743 | 59,171 | 2,209 | 209,241 | 7,211 | 153,772 | 4,929 | 33,768 | 1,114 |
| 2006 | 48,099 | 1,582 | 57,808 | 1,969 | 202,728 | 6,169 | 147,626 | 4,557 | 33,722 | 1,055 |
|
Unintentional Injuries |
||||||||||
| 2010 | 27,070 | 1,009 | 35,766 | 1,382 | 126,323 | 4,369 | 140,572 | 4,808 | 35,510 | 1,198 |
| 2009 | 26,494 | 1,023 | 35,316 | 1,526 | 120,865 | 4,322 | 124,210 | 4,247 | 32,226 | 1,022 |
| 2008 | 27,337 | 1,117 | 35,506 | 1,526 | 123,278 | 4,151 | 116,029 | 3,818 | 32,173 | 1,073 |
| 2007 | 27,235 | 1,060 | 34,422 | 1,427 | 116,887 | 4,292 | 103,457 | 3,380 | 28,960 | 1,001 |
| 2006 | 28,011 | 1,052 | 32,537 | 1,235 | 114,465 | 3,628 | 101,040 | 3,275 | 29,029 | 960 |
|
Falls |
||||||||||
| 2010 | 8,017 | 409 | 10,854 | 468 | 43,408 | 1,570 | 76,026 | 2,629 | 27,909 | 971 |
| 2009 | 7,209 | 395 | 9,601 | 519 | 40,650 | 1,506 | 66,571 | 2,325 | 25,360 | 849 |
| 2008 | 7,164 | 400 | 9,761 | 548 | 38,440 | 1,366 | 59,955 | 2,006 | 25,143 | 863 |
| 2007 | 6,534 | 310 | 8,650 | 461 | 35,309 | 1,365 | 52,769 | 1,810 | 22,442 | 832 |
| 2006 | 6,549 | 391 | 7,769 | 358 | 34,575 | 1,266 | 51,722 | 1,847 | 22,722 | 782 |
|
Motor vehicle traffic |
||||||||||
| 2010 | 7,838 | 413 | 11,671 | 630 | 32,505 | 1,492 | 18,434 | 929 | 2,003 | 146 |
| 2009 | 8,314 | 459 | 13,086 | 721 | 33,525 | 1,604 | 17,840 | 858 | 1,694 | 114 |
| 2008 | 9,095 | 449 | 13,212 | 709 | 37,719 | 1,625 | 18,557 | 775 | 2,049 | 123 |
| 2007 | 10,016 | 478 | 14,067 | 688 | 36,657 | 1,577 | 17,498 | 740 | 1,901 | 130 |
| 2006 | 11,035 | 525 | 13,900 | 667 | 36,088 | 1,510 | 17,182 | 673 | 1,856 | 126 |
4.5. Charge Estimates for Alcohol-Related ED Visits and Cost Estimates for Alcohol-Related Hospitalizations
Unlike the other topics covered in this manual showing the short trend data from 2006 to 2010, charge and cost estimates presented here are based on data from the most recent year, 2010. The charge data are available from both the NEDS and the NIS. However, the cost-to-charge ratios, necessary for converting charges to costs, are available only for the NIS and not for the NEDS. Consequently, cost estimates are presented for alcohol-related hospitalizations, whereas charge estimates rather than cost estimates are presented for alcohol-related ED visits. In general, costs are less than charges Costs tend to reflect the actual costs to produce hospital services. Charges represent the amount the hospital billed for the entire hospital stay (which does not include professional or physician fees). For each hospital, a hospital-wide cost-to-charge ratio is used, because detailed charges are not available across all HCUP states (Wier et al., 2011). A sizable proportion of ED visits and hospital stays have missing information on charges. To account for these cases where no charge data are recorded, the estimates of the aggregated charges or costs, as shown in Tables D1-2 and D2-2, are obtained by multiplying the numbers of all cases and the average charges or costs estimated from cases with valid charge or cost information. Essentially, this uses the average charges or costs based on known values to substitute for the charges or costs for cases where no charge data are recorded. Relevant tables on this topic are Tables D1-1, D1-2, D2-1, and D2-2.
Table D1-1 of Chapter II shows that in 2010, the median cost was $8,109 for males ages 12 and older who were hospitalized with the first-listed or principal diagnosis of alcohol-related conditions. The cost was $2,838 for females with the first-listed or principal diagnosis of nondependent abuse of alcohol. Table D2-2 of Chapter I shows that in 2010, the aggregate charges to patients ages 45 to 64 for their ED visits related to any alcohol-related diagnoses were $5,258.8 million, which was the highest among all age groups. Of these charges, $2,572.7 million was for ED visits related to nondependent abuse of alcohol, which was the highest among all alcohol-related diagnoses.
| First-listed alcohol-related diagnoses | Total | Sex | ||||
|---|---|---|---|---|---|---|
| Male | Female | |||||
| Median | S.E. | Median | S.E. | Median | S.E. | |
|
SOURCE: Nationwide Inpatient Sample, 2006–2010. |
||||||
|
Any alcohol-related diagnoses |
$4,182 | $176 | $4,091 | $195 | $4,416 | $154 |
|
Alcoholic psychoses |
$3,777 | $195 | $3,842 | $209 | $3,596 | $179 |
|
Alcohol dependence syndrome |
$3,194 | $148 | $3,168 | $166 | $3,318 | $124 |
|
Nondependent abuse of alcohol |
$2,942 | $86 | $2,985 | $93 | $2,838 | $113 |
|
All chronic liver disease and cirrhosis |
$8,104 | $174 | $8,109 | $186 | $8,095 | $179 |
|
Alcoholic liver disease |
$8,059 | $164 | $8,043 | $182 | $8,101 | $188 |
|
Alcohol poisoning |
$4,829 | $260 | $5,002 | $301 | $4,510 | $253 |
| All-listed alcohol-related diagnoses | Age group | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 12–20 years | 21–24 years | 25–44 years | 45–64 years | 65+ years | ||||||
| Sum | S.E. | Sum | S.E. | Sum | S.E. | Sum | S.E. | Sum | S.E. | |
|
SOURCE: Nationwide Emergency Department Sample, 2006–2010. |
||||||||||
|
Any alcohol-related diagnoses |
$500.4 | $20.5 | $592.1 | $25.7 | $3,615.2 | $146.5 | $5,285.8 | $200.1 | $1,189.5 | $49.0 |
|
Alcoholic psychoses |
$4.8 | $0.5 | $15.0 | $1.1 | $269.9 | $12.4 | $463.3 | $20.0 | $85.4 | $4.2 |
|
Alcohol dependence syndrome |
$41.6 | $3.1 | $83.6 | $5.8 | $925.0 | $41.0 | $1,651.5 | $64.9 | $300.5 | $12.3 |
|
Nondependent abuse of alcohol |
$421.8 | $18.1 | $462.8 | $20.6 | $2,188.4 | $97.4 | $2,572.7 | $109.4 | $447.2 | $19.0 |
|
All chronic liver disease and cirrhosis |
$27.4 | $2.5 | $43.0 | $3.4 | $637.5 | $35.2 | $1,528.0 | $70.2 | $503.2 | $26.6 |
|
Alcoholic liver disease |
$0.5 | $0.1 | $3.9 | $0.5 | $171.8 | $8.9 | $517.3 | $23.5 | $97.7 | $5.0 |
|
Alcohol poisoning |
$18.6 | $1.6 | $14.3 | $1.2 | $60.8 | $3.7 | $50.6 | $3.5 | $6.2 | $0.6 |
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