The sobering cost of alcohol intoxication

By Adem Lewis / in , , , , , , , , , , , , , , , , , , , /

Emergency department overcrowding is a
significant concern across the United States. Every year, in this country of 320
million people there are over a hundred and 36 million emergency department
visits. And every year this number of emergency department visits or E.D.
visits increases while the number of available beds actually drops, increasing wait
times, increasing the risk for disability and death. My health services research investigates
a reality that directly impacts emergency department overcrowding — the
care for alcohol intoxication. Did you know that up to 40 percent of people in
the emergency department are intoxicated on alcohol? For those with only alcohol
intoxication and no other medical need, this cost the health care system over
900 million dollars annually. And for those with only alcohol intoxication
they don’t need the costly comprehensive services found in emergency department.
In response to this many cities and counties have created an ingenious
rather simple service to more properly care for those intoxicated — sobering centers.
So what is a sobering center? It’s like the urgent care for alcohol. Clients are provided
a bed to rest in, vital signs monitoring, food, electrolytes, and are given what
emergency departments just do not have enough of — time. There over 27 sobering
programs across this country and dozens more cities and counties looking to open
sobering centers. Yet there’s absolutely no research on the safety or cost
efficiency of these services. My research investigates the San Francisco sobering
center, a nurse-led program initiated in 2003 through the collaboration of over
50 local stakeholders. And eight years of analysis they’re over 30,000 encounters
at the sobering center. Individuals brought in by ambulances, the police
department, outreach workers, indirectly from emergency departments. Importantly,
over 11,000 of these encounters were brought in by ambulance — directly
impacting E.D. overcrowding. And for those brought in a vast majority were able to
sober safely without any additional intervention while less than four
percent had a medical or psychiatric emergency requiring a higher level of
care. The cost savings for this service is significant. Looking only at those brought in by
ambulance, the sobering center was able to save the city over three and a half
million dollars. This was due to the cost of the sobering center being less than half that
at the emergency department. Alcohol intoxication is not going away anytime soon my first of its kind of research has
been able to show that sobering centers can be a safe, lower-cost alternative
emergency department. And importantly I’m investigating the populations of
individuals who utilize any service for public intoxication to really influence
health and emergency service policy across this country. Thank you.

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