Trends in alcohol‐attributable hospitalisations and emergency department visits by age, sex, drinking group and health condition in Ontario, Canada

• Published in: Drug and alcohol review Vol. 42; no. 4; pp. 926 - 937
• Main Authors: Smith, Brendan T., Schoer, Nicole, Sherk, Adam, Thielman, Justin, McKnight, Anthony, Hobin, Erin
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.05.2023; Wiley Subscription Services, Inc
• Subjects: Adult; Age; Alcohol; alcohol drinking; Alcohol use; alcohol‐related disorders; Attribution; Commerce; drinking behaviour; Emergency medical care; Emergency Service, Hospital; Emergency services; Ethanol; Female; Females; Health care; hospitalisation; Hospitalization; Humans; Male; Males; Ontario - epidemiology; Sales; Trends; Visits; Ontario; Ontario Canada; Canada; alcohol; alcohol-related disorders; drinking behaviour; hospitalisation; alcohol drinking
• ISSN: 0959-5236; 1465-3362
• DOI: 10.1111/dar.13629

Introduction Alcohol‐attributable harms are increasing in Canada. We described trends in alcohol‐attributable hospitalisations and emergency department (ED) visits by age, sex, drinking group, attribution and health condition. Methods Hospitalisation and ED visits for partially or wholly alcohol‐attributable health conditions by age and sex were obtained from population‐based health administrative data for individuals aged 15+ in Ontario, Canada. Population‐level alcohol exposure was estimated using per capita alcohol sales and alcohol use data. We estimated the number and rate of alcohol‐attributable hospitalisations (2008–2018) and ED visits (2008–2019) using the International Model of Alcohol Harms and Policies (InterMAHP). Results Over the study period, the modelled rates of alcohol‐attributable health‐care encounters were higher in males, but increased faster in females. Specifically, rates of alcohol‐attributable hospitalisations and ED visits increased by 300% (19–76 per 100,000) and 37% (774–1,064 per 100,000) in females, compared to 20% (322–386 per 100,000) and 2% (2563–2626 per 100,000) in males, respectively. Alcohol‐attributable ED visit rates were highest among individuals aged 15–34, however, increased faster among individuals aged 65+ (females: 266%; males: 44%) than 15–34 years (females:+17%; males: −16%). High‐volume drinkers had the highest rates of alcohol‐attributable health‐care encounters; yet, low‐/medium‐volume drinkers contributed substantial hospitalisations (11%) and ED visits (36%), with increasing rates of ED visits in females drinking low/medium volumes. Discussion and Conclusions Alcohol‐attributable health‐care encounters increased overall, and faster among females, adults aged 65+ and low‐/medium‐volume drinkers. Monitoring trends across subpopulations is imperative to inform equitable interventions to mitigate alcohol‐attributable harms.