Alcohol use disorder and healthcare utilization in patients with chronic asthma and obstructive lung disease
| Autor: | Rocio Lopez, Maeve G. MacMurdo, Joe Zein, Belinda L. Udeh |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Health (social science) Alcohol use disorder Toxicology Medicare Biochemistry Article 03 medical and health sciences Behavioral Neuroscience Pulmonary Disease Chronic Obstructive 0302 clinical medicine mental disorders medicine Humans Asthma Aged Retrospective Studies COPD Chronic Obstructive Asthma business.industry General Medicine Emergency department Middle Aged Patient Acceptance of Health Care medicine.disease Obstructive lung disease United States respiratory tract diseases 030227 psychiatry Hospitalization Alcoholism Neurology Respiratory failure Emergency medicine Cohort Female business 030217 neurology & neurosurgery |
| Zdroj: | Alcohol |
| ISSN: | 1873-6823 |
| Popis: | Alcohol use disorder (AUD) is associated with significant direct morbidity and mortality. The impact of alcohol on chronic asthma and obstructive lung disease is unknown. AUD treatment may represent a potential target to improve healthcare utilization and healthcare costs in this patient population. Utilizing data from the 2012-2015 Nationwide Readmissions Database (NRD) and Nationwide Emergency Department Sample (NEDS), patients with a primary admission diagnosis of asthma or COPD were identified. Documented substance misuse, rates of hospitalization, frequency of hospital readmission, markers of admission severity, and cost were assessed. Within the NEDS cohort, 2,048,380 patients with a diagnosis of COPD or asthma were identified. Patients with documented AUD were more likely to present with respiratory failure [OR 1.32 (1.26, 1.39); p 0.001] and more likely to require mechanical ventilation in the emergency room [OR 1.30 (1.19, 1.42); p 0.001]. Within the NRD cohort, 1,096,663 hospital admissions were identified, of which 4.1% had documented AUD. AUD was associated with an increased length of stay [percentage increase estimate: 5% (4,6); p 0.001], increased hospitalization cost, and an increased likelihood of 30-day readmission in patients with a primary admission diagnosis of COPD or asthma [OR 1.24 (1.2, 1.28); p 0.001]. AUD is associated with increased disease morbidity and healthcare utilization in patients admitted with asthma or COPD. This impact persists after adjusting for substance misuse and associated comorbidities. Identifying and treating AUD in this patient population may improve disease, patient, and health-system outcomes. |
| Databáze: | OpenAIRE |
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