Why Are Some Male Alcohol Misuse Disorder Patients High Utilisers of Emergency Health Services? An Asian Qualitative Study

• Published in: International journal of environmental research and public health Vol. 19; no. 17; p. 10795
• Main Authors: Goh, Pamela, Md Amir Ali, Lina Amirah Binte, Ou Yong, Donovan, Ong, Gabriel, Quek, Jane, Banu, Halitha, Wu, Jun Tian, Mak, Charles Chia Meng, Mao, Desmond Renhao
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30.08.2022; MDPI
• Subjects: Alcohol abuse; Alcohol withdrawal; Alcoholism; Alcoholism - epidemiology; Alcohols; Ambulances; Chronic Disease; Codes; Complications; Drinking; Drinking behavior; Emergency medical care; Emergency Medical Services; Emergency Service, Hospital; Emergency services; Environmental factors; Female; Health care; Hospitals; Humans; Informed consent; Interviews; Intoxication; Male; Males; Medical records; Middle Aged; Patients; Qualitative Research; Questionnaires; Rehabilitation; Research methodology; Sociodemographics; Asia; alcohol misuse; high utilization; emergency department; emergency services; repeated attendances
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph191710795

Certain alcohol misuse patients heavily utilise the Emergency Department (ED) and Emergency Medical Services (EMS) and may present with intoxication or long-term sequelae of alcohol misuse. Our study explored reasons for repeated ED/EMS utilisation and sought to understand perpetuating and protective factors for drinking. Face-to-face semi-structured qualitative interviews were conducted. Participants were recruited from an ED in Singapore. Interviews were audio-recorded, transcribed verbatim and underwent manual thematic analysis. Emergent themes were independently reviewed for agreement. Data from medical records, interview transcripts, and field notes were triangulated for analysis. All participants were male ( = 20) with an average age of 55.6 years ( = 8.86). Most were unemployed (75%), did not have tertiary education (75%), were divorced (55%), and had pre-existing psychiatric conditions (60%) and chronic cardiovascular conditions (75%). Reasons for utilisation included a perceived need due to symptoms, although sometimes it was bystanders who called the ambulance. ED/EMS was preferred due to the perceived higher quality and speed of care. Persistent drinking was attributed to social and environmental factors, and as a coping mechanism for stressors. Rehabilitation programs and meaningful activities reduced drinking tendencies. ED/EMS provide sought-after services for alcohol misuse patients, resulting in high utilisation. Social and medical intervention could improve drinking behaviours and decrease overall ED/EMS utilisation.