Health care usage by older alcohol -using veterans: Effects of a brief intervention to reduce risky drinking.

This research used a pre/post longitudinal design to study the effects on health care usage of a brief intervention to reduce alcohol consumption. The subjects were 205 male Veterans over age 55 who were at-risk drinkers (averaged 22 drinks per week; 84% were binge drinkers). They were a subsample of primary care patients recruited for a larger alcohol study. Informed consent to participate in all phases of the study was obtained from each patient at the initial contact. Participation in the intervention or control group was determined through block randomization. The intervention was presented in Veterans Administration (VA) outpatient clinics to half (n = 100) of the sample, while generic health advice (usual care) was provided to the control group (n = 105). This dissertation examined the effects of the intervention on the use of both inpatient and outpatient health care services in the 9 and 18 months following exposure to the intervention. Baseline surveys as well as pre- and posttest health care records were used in the analyses presented. Health care utilization was assessed by 13 measures. Types of health care measured were outpatient medical, psychiatric, alcohol and other drug-related (AOD), miscellaneous clinic care (mostly screening and therapy visits), emergency department visits, inpatient medical, psychiatric, AOD, and nursing home care, total days of hospitalization, number of hospitalizations, and average length of hospitalizations. Covariates hypothesized to be important in the use of health care, race/ethnicity, age, living alone, and educational attainment, were also examined in analysis, as well the interaction between treatment status and Stage of Change. The results showed an increased use of medical services in the short term and no change in use in the long term among those veterans who received the brief intervention to reduce drinking. African American veterans used more AOD outpatient care in the 9-month follow-up than did Caucasian veterans. Age was generally associated with more preintervention use and less post-intervention use. The minimal added costs of the intervention, as measured by health care services use, strengthen the case for development and implementation of brief alcohol interventions in the VA.PhDEducationHealth and Environmental SciencesHealth educationPublic healthUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/132765/2/9990873.pd