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Cited by 293Substance Abuse Treatment and OutcomesHealth Systems, Economic Evaluations, Quality of LifeAlcohol Consumption and Health Effects

Alcohol Interventions for Trauma Patients Treated in Emergency Departments and Hospitals: A Cost Benefit Analysis

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Gentilello, Larry M., Ebel, Beth E., Wickizer, Thomas M., Salkever, David S., Rivara, Frederick P.·2005·Annals of Surgery
DOI 10.1097/01.sla.0000157133.80396.1cPMC PMC1357055
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Abstract

OBJECTIVE: To determine if brief alcohol interventions in trauma centers reduce health care costs. SUMMARY BACKGROUND DATA: Alcohol-use disorders are the leading cause of injury. Brief interventions in trauma patients reduce subsequent alcohol intake and injury recidivism but have not yet been widely implemented. METHODS: This was a cost-benefit analysis. The study population consisted of injured patients treated in an emergency department or admitted to a hospital. The analysis was restricted to direct injury-related medical costs only so that it would be most meaningful to hospitals, insurers, and government agencies responsible for health care costs. Underlying assumptions used to arrive at future benefits, including costs, injury rates, and intervention effectiveness, were derived from published nationwide databases, epidemiologic, and clinical trial data. Model parameters were examined with 1-way sensitivity analyses, and the cost-benefit ratio was calculated. Monte Carlo analysis was used to determine the strategy-selection confidence intervals. RESULTS: An estimated 27% of all injured adult patients are candidates for a brief alcohol intervention. The net cost savings of the intervention was 89 US dollars per patient screened, or 330 US dollars for each patient offered an intervention. The benefit in reduced health expenditures resulted in savings of 3.81 US dollars for every 1.00 US dollar spent on screening and intervention. This finding was robust to various assumptions regarding probability of accepting an intervention, cost of screening and intervention, and risk of injury recidivism. Monte Carlo simulations found that offering a brief intervention would save health care costs in 91.5% of simulated runs. If interventions were routinely offered to eligible injured adult patients nationwide, the potential net savings could approach 1.82 billion US dollars annually. CONCLUSIONS: Screening and brief intervention for alcohol problems in trauma patients is cost-effective and should be routinely implemented.

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  • Prior work indicates that brief interventions lower drinking and improve outcomes in people with hazardous or harmful alcohol use.

    “Brief interventions (BI) have been shown to reduce alcohol use and improve outcomes in Hazardous and Harmful (HH) drinkers but evidence to support their use in emergency department (ED) patients is limited.”

    From A Brief Intervention Reduces Hazardous and Harmful Drinking in Emergency Department Patients (2012) · cites this paper as [19]

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  1. [11]US Department of Health and Human Services. Changing the Conversation: Improving Substance Abuse Treatment: The National Treatment Plan Initiative. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment; 2000. [Google Scholar]
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Authors
Gentilello, L. M., Ebel, B. E., Wickizer, T. M., Salkever, D. S., & Rivara, F. P.
Affiliations
  • Parkland Memorial Hospital (US)
  • University of Washington (US)
  • Johns Hopkins University (US)
Corresponding author
Gentilello, Larry M.
ORCID
Venue
Annals of Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2005-04
Volume
241
Issue
4
Pages
541-550
ISSN
0003-4932 (ISSN-L)
DOI
10.1097/01.sla.0000157133.80396.1c
PMC
PMC1357055
OpenAlex
W2030265013
Cited by
293
References
56
Citations by year
2026: 2 · 2025: 1 · 2024: 3 · 2023: 6 · 2022: 5 · 2021: 4 · 2020: 10 · 2019: 12 · 2018: 14 · 2017: 25 · 2016: 8 · 2015: 20 · 2014: 13 · 2013: 15 · 2012: 28
FWCI
13.69
Type
journal article
Language
en
Open access
Locations
  • Annals of Surgery (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Robert Wood Johnson Foundation
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
brief alcohol intervention, trauma patients, alcohol screening, cost-benefit analysis, health care costs, alcoholism, emergency department, hospitalization, cost-effectiveness
MeSH terms
Alcoholism, Cost-Benefit Analysis, Emergency Service, Hospital, Health Expenditures, Female, Humans, Male, Mass Screening, Trauma Centers, United States, Wounds and Injuries, Injury Severity Score, Cost Savings, Health Care Costs, Cost of Illness, Risk Assessment, Health Care Surveys

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