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Health Services Research & Development

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Health services utilization and cost for at-risk drinkers: rural and urban comparisons.

Nietert PJ, French MT, Kirchner J, Han X, Booth BM. Health services utilization and cost for at-risk drinkers: rural and urban comparisons. Journal of Studies On Alcohol. 2004 May 1; 65(3):353-62.

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OBJECTIVE: The purpose of this study was to examine differences between healthcare use and associated costs in rural and urban at-risk drinkers. METHOD: Primary healthcare utilization and cost data were collected from 1995 to 1998 on rural (n = 215) and urban (n = 228) cohorts of drinkers residing in six southeastern states who met criteria for at-risk drinking. Data were obtained through subject interview and from abstracts of medical and pharmacy records. RESULTS: Overall healthcare costs were not significantly different between the rural and urban cohorts. For subjects who incurred any hospital costs (including emergency room [ER] visits), however, costs were significantly greater (p < .01) for rural patients (median = dollars 2,561) than for urban patients (median = dollars 865). Hospital costs associated with patients' ER visits and any subsequent admissions were also greater (p < .01) for rural patients (median = dollars 1,004) than for urban patients (median = dollars 512). Use of healthcare services was significantly more likely to occur among women (p < .0001), individuals with lower overall self-reported physical health (p < .01) and individuals with health insurance (p < .0001). Among subjects who used healthcare services, greater costs were significantly associated with older age (p < .05), being female (p < .0001), having lower overall physical health (p < .0001) and having health insurance (p < .01). CONCLUSIONS: While overall healthcare costs are not significantly different between rural and urban residents in this sample of at-risk drinkers, there are some notable differences in the costs associated with inpatient and ER services.

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