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Home » Publications » Alcohol Epidemiologic Data Reference Manuals » Alcohol Epidemiologic Data Reference Manual, Volume 9, Number 1

U.S. Alcohol Epidemiologic Data Reference Manual, Volume 9

Alcohol-Related Emergency Department Visits and Hospitalizations and
Their Co-Occurring Drug-Related, Mental Health, and Injury Conditions in the United States: Findings from the 2006–2010 Nationwide Emergency Department Sample (NEDS) and Nationwide Inpatient Sample (NIS)

September 2013

National Institutes of Health
National Institute on Alcohol Abuse and Alcoholism
5635 Fishers Lane, MSC 9304
Bethesda, MD 20892‑9304

Acknowledgments

This publication was developed by CSR, Incorporated, under Contract No. HHSN267200800023 for the operation of the Alcohol Epidemiologic Data System (AEDS) for the Division of Epidemiology and Prevention Research (DEPR) of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH). Principal authors of this manual are Chiung M. Chen, M.A., Young-Hee Yoon, Ph.D., and Hsiao-ye Yi, Ph.D., of CSR. Ralph W. Hingson, Sc.D., Director of DEPR, contributed to the conceptualization of this manual. Aaron M. White, Ph.D., and Rosalind A. Breslow, Ph.D., of DEPR reviewed the draft. Dr. Breslow also served as NIAAA’s Project Officer on the above-referenced contract and oversaw the completion of this manual.


All material appearing in this manual is in the public domain and may be reproduced or copied without the permission of NIAAA. Citation of the source is appreciated.

 

NIH Publication No. 13‑8000

Table of Contents

List of Tables

 

List of Exhibits

 

Foreword

 

1. Introduction

 

2. Data Sources

 

2.1. Emergency Department (ED) Visit and Hospitalization Data

 

2.2. Population Data

 

3. Data Coverage

 

4. Data Tables

 

4.1. Alcohol-Related ED Visits and Hospitalizations

 

4.2. Co-occurrence of Alcohol-Related and Drug-Related ED Visits and Hospitalizations

 

4.3. Co-occurrence of Alcohol-Related and Mental Health-Related ED Visits and Hospitalizations

 

4.4. Co-occurrence of Alcohol-Related and Injury-Related ED Visits and Hospitalizations

 

4.5. Charge Estimates for Alcohol-Related ED Visits and Cost Estimates for Alcohol-Related Hospitalizations

 

References

List of Tables

Chapter I. Emergency Department Visits

Table A1. Percent distribution of emergency department visits with first-listed alcohol-related diagnoses among total emergency department visits for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A2. Percent distribution of emergency department visits with all-listed alcohol-related diagnoses among total emergency department visits for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A3. Percent distribution of emergency department visits with first-listed alcohol-related diagnoses among total emergency department visits for persons ages 12 years and older, by region, sex, and age group, United States, 2006–2010.

Table A4. Percent distribution of emergency department visits with all-listed alcohol-related diagnoses among total emergency department visits for persons ages 12 years and older, by region, sex, and age group, United States, 2006–2010.

Table A5. Percent distribution that had co-occurring drug-related diagnoses among emergency department visits with first-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A6. Percent distribution that had co-occurring drug-related diagnoses among emergency department visits with all-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A7. Percent distribution that had co-occurring mental health-related diagnoses among emergency department visits with first-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A8. Percent distribution that had co-occurring mental health-related diagnoses among emergency department visits with all-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A9. Percent distribution that had co-occurring injury-related diagnoses among emergency department visits with first-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A10. Percent distribution that had co-occurring injury-related diagnoses among emergency department visits with all-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B1. Number of emergency department visits with first-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B2. Number of emergency department visits with all-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B3. Number of emergency department visits with first-listed alcohol-related diagnoses for persons ages 12 years and older, by region, sex, and age group, United States, 2006–2010.

Table B4. Number of emergency department visits with all-listed alcohol-related diagnoses for persons ages 12 years and older, by region, sex, and age group, United States, 2006–2010.

Table B5. Number of emergency department visits with first-listed alcohol-related diagnoses that had co-occurring drug-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B6. Number of emergency department visits with all-listed alcohol-related diagnoses that had co-occurring drug-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B7. Number of emergency department visits with first-listed alcohol-related diagnoses that had co-occurring mental health-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B8. Number of emergency department visits with all-listed alcohol-related diagnoses that had co-occurring mental health-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B9. Number of emergency department visits with first-listed alcohol-related diagnoses that had co-occurring injury-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B10. Number of emergency department visits with all-listed alcohol-related diagnoses that had co-occurring injury-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C1. Rate of emergency department visits with first-listed alcohol-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C2. Rate of emergency department visits with all-listed alcohol-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C3. Rate of emergency department visits with first-listed alcohol-related diagnoses per 10,000 population for persons ages 12 years and older, by region, sex, and age group, United States, 2006–2010.

Table C4. Rate of emergency department visits with all-listed alcohol-related diagnoses per 10,000 population for persons ages 12 years and older, by region, sex, and age group, United States, 2006–2010.

Table C5. Rate of emergency department visits with first-listed alcohol-related diagnoses that had co-occurring drug-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C6. Rate of emergency department visits with all-listed alcohol-related diagnoses that had co-occurring drug-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C7. Rate of emergency department visits with first-listed alcohol-related diagnoses that had co-occurring mental health-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C8. Rate of emergency department visits with all-listed alcohol-related diagnoses that had co-occurring mental health-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C9. Rate of emergency department visits with first-listed alcohol-related diagnoses that had co-occurring injury-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C10. Rate of emergency department visits with all-listed alcohol-related diagnoses that had co-occurring injury-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table D1-1. Median charge of emergency department visits with first-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2010.

Table D1-2. Total charge (in millions) of emergency department visits with first-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2010.

Table D2-1. Median charge of emergency department visits with all-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2010.

Table D2-2. Total charge (in millions) of emergency department visits with all-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2010.

Chapter II. Hospitalizations

Table A1. Percent distribution of hospitalizations with first-listed alcohol-related diagnoses among total hospitalizations for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A2. Percent distribution of hospitalizations with all-listed alcohol-related diagnoses among total hospitalizations for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A3. Percent distribution of hospitalizations with first-listed alcohol-related diagnoses among total hospitalizations for persons ages 12 years and older, by region, sex, and age group, United States, 2006–2010.

Table A4. Percent distribution of hospitalizations with all-listed alcohol-related diagnoses among total hospitalizations for persons ages 12 years and older, by region, sex, and age group, United States, 2006–2010.

Table A5. Percent distribution that had co-occurring drug-related diagnoses among hospitalizations with first-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A6. Percent distribution that had co-occurring drug-related diagnoses among hospitalizations with all-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A7. Percent distribution that had co-occurring mental health-related diagnoses among hospitalizations with first-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A8. Percent distribution that had co-occurring mental health-related diagnoses among hospitalizations with all-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A9. Percent distribution that had co-occurring injury-related diagnoses among hospitalizations with first-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table A10. Percent distribution that had co-occurring injury-related diagnoses among hospitalizations with all-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B1. Number of hospitalizations with first-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B2. Number of hospitalizations with all-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B3. Number of hospitalizations with first-listed alcohol-related diagnoses for persons ages 12 years and older, by region, sex, and age group, United States, 2006–2010.

Table B4. Number of hospitalizations with all-listed alcohol-related diagnoses for persons ages 12 years and older, by region, sex, and age group, United States, 2006–2010.

Table B5. Number of hospitalizations with first-listed alcohol-related diagnoses that had co-occurring drug-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B6. Number of hospitalizations with all-listed alcohol-related diagnoses that had co-occurring drug-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B7. Number of hospitalizations with first-listed alcohol-related diagnoses that had co-occurring mental health-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B8. Number of hospitalizations with all-listed alcohol-related diagnoses that had co-occurring mental health-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B9. Number of hospitalizations with first-listed alcohol-related diagnoses that had co-occurring injury-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table B10. Number of hospitalizations with all-listed alcohol-related diagnoses that had co-occurring injury-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C1. Rate of hospitalizations with first-listed alcohol-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C2. Rate of hospitalizations with all-listed alcohol-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C3. Rate of hospitalizations with first-listed alcohol-related diagnoses per 10,000 population for persons ages 12 years and older, by region, sex, and age group, United States, 2006–2010.

Table C4. Rate of hospitalizations with all-listed alcohol-related diagnoses per 10,000 population for persons ages 12 years and older, by region, sex, and age group, United States, 2006–2010.

Table C5. Rate of hospitalizations with first-listed alcohol-related diagnoses that had co-occurring drug-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C6. Rate of hospitalizations with all-listed alcohol-related diagnoses that had co-occurring drug-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C7. Rate of hospitalizations with first-listed alcohol-related diagnoses that had co-occurring mental health-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C8. Rate of hospitalizations with all-listed alcohol-related diagnoses that had co-occurring mental health-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C9. Rate of hospitalizations with first-listed alcohol-related diagnoses that had co-occurring injury-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table C10. Rate of hospitalizations with all-listed alcohol-related diagnoses that had co-occurring injury-related diagnoses per 10,000 population for persons ages 12 years and older, by sex and age group, United States, 2006–2010.

Table D1-1. Median cost of hospitalizations with first-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2010.

Table D1-2. Total cost (in millions) of hospitalizations with first-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2010.

Table D2-1. Median cost of hospitalizations with all-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2010.

Table D2-2. Total cost (in millions) of hospitalizations with all-listed alcohol-related diagnoses for persons ages 12 years and older, by sex and age group, United States, 2010

List of Exhibits

Exhibit 1. ICD-9-CM Codes for Alcohol-Related Diagnoses

Exhibit 2. ICD-9-CM Codes for Drug-Related Diagnoses

Exhibit 3. ICD-9-CM Codes for Mental Health-Related Diagnoses

Exhibit 4. ICD-9-CM Codes for Injury-Related Diagnoses

Foreword

The National Institute on Alcohol Abuse and Alcoholism (NIAAA), a part of the National Institutes of Health, is the primary Federal agency that conducts and supports epidemiologic, biomedical and behavioral research related to the causes, consequences, treatment, and prevention of alcohol-related problems.

The Alcohol Epidemiologic Data Reference Manuals (AEDRMs) produced by the Alcohol Epidemiologic Data System (AEDS) of NIAAA provide detailed epidemiologic data useful to researchers, health care planners, and others interested in the topics of alcohol use, abuse, and associated morbidity and mortality.

This manual is the first publication in Volume 9 of the AEDRM series, presenting an extensive compilation of data on alcohol-related emergency department visits and hospitalizations and their co-occurring drug-related conditions, mental health disorders, and injuries. The source data for the manual came from the 2006–2010 Nationwide Emergency Department Sample (NEDS) and Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP), sponsored by Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services. The NEDS and the NIS are the largest national databases of hospital-based emergency department (ED) visits and hospital inpatient stays in the United States.

Other volumes of the AEDRM series include information on alcohol use and alcohol use disorders, per capita alcohol consumption, liver cirrhosis mortality, county alcohol-problem indicators, hospital discharges with alcohol-related conditions, and State trends in drinking behaviors and alcohol-related mortality. We hope that these documents will serve as a useful reference for both researchers and others interested in the alcoholism field.

 

Kenneth R. Warren, Ph.D.

Acting Director

National Institute on Alcohol Abuse and Alcoholism

1. Introduction

This manual presents national statistics on alcohol-related morbidity in the United States based on patient data from emergency department (ED) visits and hospital discharge records. It was compiled and published by the Alcohol Epidemiologic Data System (AEDS) of the Division of Epidemiology and Prevention Research (DEPR), National Institute on Alcohol Abuse and Alcoholism (NIAAA) as part of a series of alcohol epidemiologic data reference manuals. These manuals serve as tools for monitoring trends in alcohol consumption and related problems. While several of the earlier manuals have focused on alcohol-related mortality (Caces, Stinson, & Elliott, 1991; Grant, 1985; Stinson & Nephew, 1996; Stinson & Proudit, 1994), none have yet reported data on alcohol-related morbidity and comorbidity. One of the NIAAA surveillance reports that AEDS has maintained since 1987 reports trends in alcohol-related morbidity based on data from the annual National Hospital Discharge Survey conducted by the National Center for Health Statistics (NCHS), but using hospital discharge data alone misses a substantial proportion of patients who are treated in emergency rooms. To expand our morbidity surveillance to alcohol-related emergency department (ED) visits, this manual presents the recently available data from the Nationwide Emergency Department Sample (NEDS) as well as the Nationwide Inpatient Sample (NIS). Together, these two databases provide a more complete picture of health care utilization for alcohol-related health problems.

This manual is the first to present the prevalence of co-occurrence of drug-related, mental health-related, and injury-related diagnoses among alcohol-related ED visits and hospitalizations. In addition, it provides short trends in ED visits and hospitalization rates for several specific alcohol-related diagnoses, including alcoholic psychoses, alcohol dependence syndrome, nondependent abuse of alcohol, chronic liver diseases and cirrhosis, and alcohol poisoning, as well as their co-occurring conditions for drug-related, mental health-related, and injury-related diagnoses. Against the backdrop of overcrowding of ED health care services (Institute of Medicine, 2004) and a rising trend of utilization among patients with mental health and substance use disorders in the ED setting (Larkin et al., 2005), this manual is timely and especially relevant for the intervention and prevention purposes.

2. Data Sources

2.1. Emergency Department (ED) Visit and Hospitalization Data

The data presented in this manual are based on the annual ED and hospitalization data from the Nationwide Emergency Department Sample (NEDS) and the Nationwide Inpatient Sample (NIS) respectively, from 2006 to 2010. The NEDS and the NIS are part of the Healthcare Cost and Utilization Project (HCUP), a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services. The NEDS and the NIS are unique and powerful databases of emergency department visits and of hospital inpatient stays, respectively. Researchers and policymakers use the NEDS and the NIS to identify, track, and analyze national and regional trends in hospital emergency department and hospital care utilization, access, charges, and quality.

The NEDS is the largest publicly available all-payer ED database in the United States, containing discharge information on all ED visits from a stratified sample of hospital-based EDs in the participating states that provide the HCUP with ED data. The NEDS is constructed using records from two sets of the HCUP state databases: the State Emergency Department Databases (SEDD) and the State Inpatient Databases (SID). The SEDD capture information on more than 80% of ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). The SID capture information on patients initially seen in the emergency room and then admitted to the same hospital. Accordingly, the NEDS provides information on care that began in the emergency department, regardless of whether the patients were treated and released or admitted to the hospital. Each year the NEDS contains about 25 to 30 million records for ED visits from over 950 hospitals, approximating a 20-percent stratified sample of U.S. hospital-based EDs. The numbers of EDs included in the NEDS from 2006 to 2010 are 955, 966, 980, 964, and 961, respectively. The numbers of participating states included in the NEDS from 2006 to 2010 are 24, 27, 28, 29, and 28, respectively.

The NIS is the largest publicly available all-payer inpatient care database in the United States, containing discharge information on all inpatient stays from a 20% stratified sample of hospitals in the states that participated in the HCUP. The NIS is constructed using records from the SID. Each year the NIS contains about 8 million records for inpatient stays from about 1,000 hospitals, approximating a 20-percent stratified sample of U.S. community hospitals. The numbers of hospitals included in the NIS from 2006 to 2010 are 1045, 1044, 1056, 1050, and 1051, respectively. The numbers of participating states included in the NIS from 2006 to 2010 are 30, 40, 42, 44, and 45, respectively.

Both the NEDS and NIS samples are based on U.S. community hospitals. The U.S. community hospitals are identified by the American Hospital Association (AHA) Annual Survey of Hospitals to be “all non-Federal, short-term, general, and other specialty hospitals, excluding hospital units of institutions.” Included among community hospitals are specialty hospitals such as obstetrics-gynecology, ear-nose-throat, short-term rehabilitation, orthopedic, and pediatric institutions. Also included are public hospitals, academic medical centers, and long-term acute care facilities. These facilities provide acute care services to patients who need long-term hospitalization (stays of more than 25 days). Excluded are short-term rehabilitation hospitals, long-term non-acute care hospitals, psychiatric hospitals, and alcoholism/chemical dependency treatment facilities.

The NEDS and the NIS share a similar sampling design referred to as the stratified, single-stage cluster sampling. A stratified random sample of hospital-based EDs (or hospitals) is drawn from the sampling frame (namely SEDD and SID for NEDS, and SID for NIS), and then all ED visits from selected hospital-based EDs (or discharges from hospitals) are included. Stratifying the hospital-based EDs (or hospitals) on important hospital-based ED (or hospital) characteristics ensures that the stratified sample is representative of the target universe—all U.S. community hospital-based EDs for the NEDS, and all U.S. community hospitals for the NIS.

Five hospital characteristics are used as stratifiers for creating the NEDS and the NIS samples. Four of these are the same for both samples: U.S. regions (Northeast, Midwest, West, or South); location (urban or rural); teaching status (teaching or non-teaching); and ownership (government non-Federal or public, private not-for-profit or voluntary, or private investor-owned or proprietary). The fifth stratifier for the NIS is hospital bed size (small, medium, or large, based on the number of hospital beds) and for the NEDS is the trauma center designation (level I, II, and III). A trauma center is a hospital equipped to provide comprehensive emergency medical services to patients with traumatic injuries 24 hours a day, 365 days per year. The trauma-level designation is a modified version of the Trauma Information Exchange Program (TIEP) trauma-level designation. Once the institutions (i.e., hospital-based EDs or hospitals) have been stratified, a 20-percent random sample is taken, and all patient records in these institutions will be used to construct the NEDS and the NIS.

It is important to note that the NEDS and the NIS contain event-level or discharge-level records, not patient-level records. This means that individual patients who visit the ED multiple times in 1 year may be present in the NEDS multiple times, and that individual patients who are hospitalized multiple times in 1 year may be present in the NIS multiple times. Therefore, estimates generated from these databases are referred to as ED visits or hospitalizations rather than patients.

The ED visit or discharge weight variable provided in the NEDS or NIS database is applied to the data tables in this manual to produce national or regional representative estimates. To indicate the precision of the estimates, standard errors are presented. Standard errors can be used to determine if differences between two estimates are statistically significant, or to construct confidence intervals for sample estimates of population statistics. The Taylor-series linearization method was used to calculate standard errors, taking into account the cluster and stratification aspects of the NEDS and NIS sample design using SUDAAN (Research Triangle Institute, 2008), a computer program that uses appropriate statistical techniques to adjust for sample design effects.

Interested readers may consult the HCUP Website, http://www.hcup-us.ahrq.gov, for more thorough descriptions about the NEDS and the NIS and for detailed information on the weighting of these databases and the calculation of standard errors.

2.2. Population Data

To calculate population-based rates in this manual, population data were used as the denominator while numbers estimated from the NEDS and the NIS were used as the numerator. The population data used in this manual were obtained from the U.S. Census Bureau, including Intercensal Estimates of the Resident Population by Single Year of Age and Sex for States and the United States: April 1, 2000 to July 1, 2010 (U.S. Census Bureau, 2011a) and Intercensal Estimates of the Resident Population for the United States, Regions, States, and Puerto Rico: April 1, 2000 to July 1, 2010 (U.S. Census Bureau, 2011b).

3. Data Coverage

Data provided in this manual cover four broad categories of medical conditions—alcohol-related diagnoses plus three co-occurring condition categories (drug-related diagnoses, mental health-related diagnoses, and injury diagnoses) among ED visits and hospital discharges of persons ages 12 and older. The medical conditions are ascertained by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) as indicated on patient discharge records in the NEDS and the NIS. Exhibits 1–4 list the ICD-9-CM codes used in this manual to define the four broad categories (and their subcategories), respectively.

On each patient record, the NEDS contains up to 15 diagnoses, and the NIS contains up to 25 diagnoses (15 before the 2009 NIS). In this manual, health condition categories are presented as the first-listed diagnoses as well as all-listed diagnoses. For hospital-based inpatient services, the first-listed diagnosis is the principal diagnosis, defined by the ICD-9-CM coding guidelines as the “condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care.” For hospital-based ED services, the first-listed diagnosis would be the “code for the diagnosis, condition, problem or other reason for encounter/visit shown in the medical record to be chiefly responsible for the services provided” (Senathirajah et al., 2011). To qualify for an all-listed diagnosis of a certain condition category, any one of the ICD-9-CM codes for that condition category appearing as a diagnosis on the discharge record, regardless of its location, would suffice. There are also up to four external cause-of-injury codes (E-codes) retained in separate data elements on each patient record. For injury or poisonings that were indicated by E-codes, the identification of these cases was based on all available E-codes on the discharge records, because the first-listed E-code is not necessarily the underlying or principal cause of the injury. In this manual, the number and rate for all-listed diagnoses pertain to the count of events (either ED visits or hospital stays) that involve one or more diagnoses for a given condition category, not the count of diagnoses.

Exhibit 1. ICD-9-CM Codes for Alcohol-Related Diagnoses

Alcohol-Related Diagnoses

Classification Codes in ICD-9-CM

Note: Alcohol-related diagnosis codes were selected according to NIAAA’s surveillance report on alcohol-related morbidity (Chen & Yi, 2012). Alcohol poisoning was included according to NCHS’s definition of alcohol-induced conditions (Murphy, 2000).

Alcoholic psychoses

291.0

Alcohol withdrawal delirium

291.1

Alcohol amnestic syndrome

291.2

Other alcoholic dementia

291.3

Alcohol withdrawal hallucinosis

291.4

Idiosyncratic alcohol intoxication

291.5

Alcoholic jealousy

291.8

Other specified alcoholic psychosis

291.9

Unspecified alcoholic psychosis

Alcohol dependence syndrome

303.0

Acute alcoholic intoxication

303.9

Other and unspecified alcohol dependence

357.5

Alcoholic Polyneuropathy

425.5

Alcoholic Cardiomyopathy

535.3

Alcoholic Gastritis

Nondependent abuse of alcohol

305.0

Nondependent abuse of alcohol

Chronic liver disease and cirrhosis

 

 

Alcoholic liver disease

571.0

Alcoholic fatty liver

571.1

Acute alcoholic hepatitis

571.2

Alcoholic cirrhosis of liver

571.3

Alcoholic liver damage, unspecified

Other specified liver cirrhosis without mention of alcohol

571.4

Chronic hepatitis

571.6

Biliary cirrhosis

571.8

Other chronic nonalcoholic liver disease

572.3

Portal hypertension

Unspecified liver cirrhosis without mention of alcohol

571.5

Cirrhosis of liver without mention of alcohol

571.9

Unspecified chronic liver disease without mention of alcohol

Alcohol poisoning

790.3

Excessive blood level of alcohol

980

Toxic effect of alcohol

E860

Accidental poisoning by alcohol, n.e.c.

 

Exhibit 2. ICD-9-CM Codes for Drug-Related Diagnoses

Drug-Related Diagnoses

Classification Codes in ICD-9-CM

Note: Drug-related diagnosis codes were selected according to NCHS’s definition of drug-induced conditions (Murphy, 2000).

Drug psychoses

292.0

Drug withdrawal syndrome

292.1

Paranoid and/or hallucinatory states related by drugs

292.2

Pathological drug intoxication

292.8

Other specified drug-related mental disorders

292.9

Unspecified drug-related mental disorder

Drug dependence

304.0

Opioid type dependence

304.1

Barbiturate and similarly acting sedative or hypnotic dependence

304.2

Cocaine dependence

304.3

Cannabis dependence

304.4

Amphetamine and other psychostimulant dependence

304.5

Hallucinogen dependence

304.6

Other specified drug dependence

304.7

Combinations of opioid type drug with any other

304.8

Combination of drug dependence excluding opioid type drug

304.9

Unspecified drug dependence

Nondependent abuse of drugs

305.2

Cannabis abuse

305.3

Hallucinogen abuse

305.4

Barbiturate and similarly acting sedative or hypnotic abuse

305.5

Opioid abuse

305.6

Cocaine abuse

305.7

Amphetamine or related acting sympathomimetic abuse

305.8

Antidepressant type abuse

305.9

Other, mixed, or unspecified drug abuse

Poisoning by drugs, medicinal and biological substances

960

Poisoning by antibiotics

961

Poisoning by other anti-infectives

962

Poisoning by hormones and synthetic substitutes

963

Poisoning primarily systemic agents

964

Poisoning by agents primarily affecting blood constituents

965

Poisoning by analgesic, antipyretics, and antirheumatics

966

Poisoning by anticonvulsants and anti-parkinsonism drugs

967

Poisoning by sedatives and hypnotics

968

Poisoning by other central nervous system depressants and anesthetics

969

Poisoning by psychotropic agents

970

Poisoning by central nervous system stimulants

971

Poisoning by drugs primarily affecting the autonomic nervous system

972

Poisoning by agents primarily affecting the cardiovascular system

973

Poisoning by agents primarily affecting the gastrointestinal system

974

Poisoning by water, mineral, and uric acid metabolism drugs

975

Poisoning by agents primarily acting on the smooth and skeletal muscles and respiratory system

976  

Poisoning by agents primarily affecting skin and mucous membrane, ophthalmological, otorhinolaryngological, and dental drugs

977

Poisoning by other and unspecified drugs and medicinal substances

978

Poisoning by bacterial vaccines

979

Poisoning by other vaccines and biological substances

Accidental drug poisoning

E850

Analgesics, antipyretics, and antirheumatics

E851

Barbiturates

E852

Other sedatives and hypnotics

E853

Tranquilizers

E854

Other psychotropic agents

E855

Other drugs acting on central and autonomic nervous system

E856

Antibiotics

E857

Other anti-infectives

E858

Other drugs

Suicidal drug poisoning

E950.0

Analgesics, antipyretics, and antirheumatics

E950.1

Barbiturates

E950.2

Other sedatives and hypnotics

E950.3

Tranquilizers and other psychotropic agents

E950.4

Other specified drugs and medicinal substances

E950.5

Unspecified drug or medicinal substance

Assault by drugs and medicinal substances

E962.0

Assault by drugs and medicinal substances

Poisoning by solid or liquid substances, undetermined whether accidentally or purposely inflicted due to drugs

E980.0

Analgesics, antipyretics, and antirheumatics

E980.1

Barbiturates

E980.2

Other sedatives and hypnotics

E980.3

Tranquilizers and other psychotropic agents

E980.4

Other specified drugs and medicinal substances

E980.5

Unspecified drug or medicinal substance

 

Exhibit 3. ICD-9-CM Codes for Mental Health-Related Diagnoses

Mental Health-Related Diagnoses

Classification Codes in ICD-9-CM

Adjustment disorders

309.0, 309.1, 309.22, 309.23, 309.24, 309.28, 309.29, 309.3, 309.4 309.82, 309.83, 309.89, 309.9

Anxiety disorders

293.84, 300.00–300.02, 300.09, 300.10, 300.20–300.23, 300.29, 300.3, 300.5, 300.89, 300.9, 308.0–308.4, 308.9, 309.81, 313.0, 313.1, 313.21, 313.22, 313.3, 313.82, 313.83

Mood disorders:

 

Bipolar disorders

296.00–296.06, 296.10–296.16, 296.40–296.46, 296.50–296.56, 296.60–296.66, 296.7, 296.80–296.82, 296.89, 296.90, 296.99

Depressive disorders

293.83, 296.20–296.26, 296.30–296.36, 300.4, 311

Personality disorders

301.0, 301.10–301.13, 301.20–301.22, 301.3, 301.4, 301.50, 301.51, 301.59, 301.6, 301.7, 301.81–301.84, 301.89, 301.9

Schizophrenia and other psychotic disorders

293.81, 293.82, 295.00–295.05, 295.10–295.15, 295.20–295.25, 295.30–295.35, 295.40–295.45, 295.50–295.55, 295.60–295.65, 295.70–295.75, 295.80–295.85, 295.90–295.95, 297.0–297.3, 297.8, 297.9, 298.0–298.4, 298.8, 298.9

All other mental disorders:

 

Attention deficit, and amnestic and other cognitive disorders

312.00–312.03, 312.10–312.13, 312.20–312.23, 312.4, 312.8, 312.81, 312.82, 312.89, 312.9, 313.81, 314.00, 314.01, 314.1, 314.2, 314.8, 314.9

Disorders usually diagnosed in infancy, childhood, or adolescence

299.00, 299.01, 299.10, 299.11, 299.80, 299.81, 299.90, 299.91, 307.20, 307.21–307.23, 307.3, 307.6, 307.7, 309.21, 313.23, 313.89, 313.9

Impulse control disorders, not elsewhere classified

312.30–312.35, 312.39

Miscellaneous disorders, including eating disorders, mental disorders in pregnancy, dissociative disorders, factitious disorders, sleep disorders, and somatoform disorders

293.89, 293.9 300.11–300.16, 300.19, 300.6, 300.7, 300.81, 300.82, 302.1–302.4, 302.50–302.53, 302.6, 302.70–302.76, 302.79, 302.81–302.85, 302.89, 302.9, 306.0–306.4, 306.50–306.53, 306.59, 306.6–306.9, 307.1, 307.40–307.49, 307.50–307.54, 307.59, 307.80, 307.81, 307.89, 310.1, 316, 648.40–648.44, V40.2, V40.3, V40.9, V67.3

 

Exhibit 4. ICD-9-CM Codes for Injury-Related Diagnoses.

Injury-Related Diagnoses

Classification Codes in ICD-9-CM

Note: The ICD-9-CM codes used in this manual to identify injuries are adopted from the CDC guideline (Thomas & Johnson, 2012), with a minor modification that E849 (place of injury occurrence) was excluded from the list. E849 is intended to provide supplemental information for other E-codes, including E-codes for injury and non-injury cases. Based on our analysis of the data, almost all cases that had E849 as the only E-code on record were related to complications/adverse effects of surgical and medical care procedures. Excluding E849 prevents incorrectly identifying non-injury cases as injury cases.

Any injury-related diagnoses

800–909.2, 909.4, 909.9, 910–994.9, 995.50–995.59,  995.80–995.85, E800–E848, E850–E869, E880–E929, E950–E999

Unintentional injuries

E800–E848, E850–E869, E880–E929

Falls

E880.0–E886.9, E888

Struck by or against objects or persons

E916–E917.9

Motor vehicle traffic

E810.0–E819.9

Cut or pierce

E920.0–E920.9

Poisoning

E850–E858, E859–E869

Intentional injuries

E950–E959, E960–E969, E979, E999.1

 

4. Data Tables

Four sets of data tables (A, B, C, and D series) based on the NEDS and the NIS for ED visits and hospitalizations are provided in Chapter I and Chapter II, respectively. In each chapter, Tables A1–A10 present the percentage of events (i.e., ED visits or hospitalizations); Tables B1–B10 present the number of events; Tables C1–C10 present the rate of events in the population; and Tables D1-1 to D2-2 present the cost or charge of these events. In each table, data are shown for both sexes and all ages 12 and older combined, separately for males and females ages 12 and older, and separately for both sexes combined in each of five age categories (12–20, 21–24, 25–44, 45–64, and 65 and older). Because the same scheme is used to number the tables in the two chapters, the chapter number is indicated at the top outside corner on each page of the tables. This will help readers to easily tell whether a specific table refers to ED visits or hospitalizations.

It is important to note that the numbers presented in the data tables are estimates, because they are derived from a representative sample of hospitals and all the discharges within the sampled hospitals. In a sample, each visit/discharge represents one or more visits/discharges in the population to which the estimates apply. To enable readers to assess the precision of the estimates provided, each estimate is accompanied by a value for the standard error of the estimate (labeled S.E. in the tables). Multiplying the standard error by 1.96 provides a margin of error above and below each estimate. This range defines a 95-percent confidence interval that will have a 95-percent chance of including the true value being estimated. All standard errors in this manual were calculated using SUDAAN, as discussed earlier. Estimates with very large standard errors or based on very small samples can be extremely unreliable. Following the HCUP data suppression rule, estimates derived from 10 or fewer records are not reported. Tables cells suppressed under this rule are marked by a “–” symbol.

The following sections discuss the tables related to the major topics covered in the manual. Portions of selected tables are shown as examples on the following pages, in which certain numbers cited in the text are boldfaced for illustration purposes.

4.1. Alcohol-Related ED Visits and Hospitalizations

As described earlier, Exhibit 1 lists the specific medical conditions and their associated ICD-9-CM codes that comprise the alcohol-related diagnoses for defining alcohol-related ED visits and hospitalizations in this manual. These alcohol-related diagnoses include alcoholic psychoses; alcohol dependence syndrome; nondependent abuse of alcohol; chronic liver disease and cirrhosis, such as alcoholic liver disease; and alcohol poisoning. Relevant tables on this topic are Tables A1–A4, B1–B4, and C1–C4.

For example, Table A1 of Chapter I shows that 1.1276 percent of ED visits in 2010 for those ages 12 and older had a first-listed diagnosis of alcohol-related conditions. The percentage of males (1.8767) was about 3 times as high as that of females (0.5629). In addition, 0.5745 percent of the ED visits had a diagnosis of nondependent abuse of alcohol, a percentage that had increased from 0.4791 percent in 2006.

 

Chapter I, Table A1. [Percent distribution of emergency department visits with first-listed alcohol-related diagnoses]

First-listed alcohol-related diagnoses by year

Total Sex
Male Female
Percent S.E. Percent S.E. Percent S.E.

SOURCE: Nationwide Emergency Department Sample, 2006–2010.

Any alcohol-related diagnoses

           
2010 1.1276 0.0366 1.8767 0.0656 0.5629 0.0151
2009 1.1017 0.0312 1.8296 0.0577 0.5535 0.0126
2008 1.0692 0.0349 1.7505 0.0633 0.5477 0.0140
2007 1.0275 0.0305 1.6658 0.0550 0.5323 0.0126
2006 0.9684 0.0270 1.5633 0.0481 0.5020 0.0114

Alcoholic psychoses

           
2010 0.1696 0.0074 0.3003 0.0134 0.0710 0.0031
2009 0.1753 0.0081 0.3130 0.0147 0.0716 0.0035
2008 0.1588 0.0070 0.2789 0.0128 0.0669 0.0030
2007 0.1529 0.0083 0.2693 0.0154 0.0626 0.0030
2006 0.1406 0.0055 0.2447 0.0095 0.0590 0.0026

Alcohol dependence syndrome

           
2010 0.2812 0.0153 0.4902 0.0283 0.1237 0.0058
2009 0.2697 0.0130 0.4653 0.0235 0.1225 0.0055
2008 0.2491 0.0133 0.4232 0.0238 0.1157 0.0058
2007 0.2444 0.0123 0.4126 0.0214 0.1138 0.0057
2006 0.2255 0.0106 0.3801 0.0191 0.1043 0.0045

Nondependent abuse of alcohol

           
2010 0.5745 0.0257 0.9354 0.0462 0.3025 0.0106
2009 0.5486 0.0209 0.8925 0.0392 0.2894 0.0081
2008 0.5472 0.0219 0.8795 0.0396 0.2929 0.0088
2007 0.5132 0.0174 0.8128 0.0311 0.2808 0.0077
2006 0.4791 0.0183 0.7585 0.0337 0.2600 0.0072

 

Chapter I, Table A2. [Percent distribution of emergency department visits with all-listed alcohol-related diagnoses]
  All-listed alcohol-related diagnoses by year   Total   Sex
  Male   Female
  Percent   S.E.   Percent   S.E.   Percent   S.E.

SOURCE: Nationwide Emergency Department Sample, 2006–2010.

Any alcohol-related diagnoses

           
2010 3.5591 0.0640 5.6673 0.1061 1.9699 0.0324
2009 3.3928 0.0603 5.4128 0.1026 1.8722 0.0302
2008 3.2974 0.0616 5.2249 0.1002 1.8211 0.0325
2007 3.1593 0.0605 4.9951 0.1011 1.7341 0.0305
2006 3.0447 0.0550 4.7977 0.0893 1.6705 0.0289

Alcoholic psychoses

           
2010 0.3613 0.0114 0.6400 0.0204 0.1512 0.0049
2009 0.3701 0.0127 0.6568 0.0227 0.1543 0.0056
2008 0.3489 0.0117 0.6107 0.0200 0.1486 0.0058
2007 0.3329 0.0127 0.5828 0.0228 0.1391 0.0051
2006 0.3154 0.0093 0.5469 0.0157 0.1340 0.0044

Alcohol dependence syndrome

           
2010 1.1591 0.0305 1.9857 0.0526 0.5359 0.0140
2009 1.1433 0.0289 1.9491 0.0502 0.5366 0.0138
2008 1.0819 0.0307 1.8287 0.0520 0.5103 0.0154
2007 1.0394 0.0327 1.7494 0.0567 0.4885 0.0150
2006 0.9704 0.0271 1.6216 0.0452 0.4599 0.0132

Nondependent abuse of alcohol

           
2010 1.8390 0.0441 3.0084 0.0740 0.9574 0.0219
2009 1.7223 0.0401 2.8202 0.0693 0.8953 0.0190
2008 1.7197 0.0384 2.7948 0.0634 0.8958 0.0192
2007 1.6698 0.0367 2.6978 0.0614 0.8712 0.0183
2006 1.6551 0.0368 2.6637 0.0618 0.8644 0.0181

 

Table A2 of Chapter I shows that the percentage of ED visits with an all-listed diagnosis of alcohol-related conditions (3.5591) was about 3 times as high as that for first-listed (1.1276). While ED visits for all-listed alcohol psychoses (0.3613) was twice as high as that for first-listed (0.1696), all-listed alcohol dependence syndrome (1.1591) was about 4 times as high as that for first-listed (0.2812).

As shown in Table B2 of Chapter II, the number of hospitalizations among male patients ages 12 and older with a diagnosis of alcohol dependence syndrome increased from 625,651 in 2006 to 739,813 in 2010. The number of hospitalizations among female patients with a diagnosis of nondependent abuse of alcohol increased from 193,942 in 2006 to 220,499 in 2010.

The population rates corresponding to the numbers reported in Table B2 of Chapter II are shown in Table C2 of Chapter II. The rate of hospitalization for males ages 12 and older with a diagnosis of alcohol dependence syndrome increased from 51.1823 per 10,000 population in 2006 to 58.1953 per 10,000 population in 2010. The rate of hospitalizations for females with a diagnosis of nondependent abuse of alcohol increased from 15.1053 per 10,000 population in 2006 to 16.5391 per 10,000 population in 2010.

 

Chapter II, Table B2. [Number of hospitalizations with all-listed alcohol-related diagnoses]
All-listed alcohol-related diagnoses by year Total Sex
Male Female
Number S.E. Number S.E. Number S.E.

SOURCE: Nationwide Inpatient Sample, 2006–2010.

Alcohol dependence syndrome

           
2010 1,013,634 40,892 739,813 31,856 273,614 10,629
2009 968,922 39,678 707,382 30,919 261,352 10,084
2008 919,020 40,200 660,481 30,130 258,266 11,425
2007 865,866 32,988 628,827 25,703 236,513 8,670
2006 855,480 38,351 625,651 29,891 229,477 9,378

Nondependent abuse of alcohol

           
2010 774,177 28,020 553,207 20,947 220,499 7,551
2009 701,914 25,176 500,419 18,748 201,038 6,888
2008 660,381 24,345 467,762 17,630 192,277 7,230
2007 686,721 26,283 488,959 20,082 197,302 6,801
2006 700,593 27,648 506,342 21,067 193,942 7,160

All chronic liver disease and cirrhosis

           
2010 852,354 24,173 497,794 14,920 354,505 9,929
2009 796,890 23,307 465,795 13,753 331,003 10,069
2008 731,913 22,756 428,432 13,839 303,380 9,369
2007 660,920 17,516 392,988 11,446 267,789 6,627
2006 633,730 17,320 377,263 11,068 256,381 6,840

Alcohol poisoning

           
2010 29,822 1,665 16,400 1,082 13,423 669
2009 27,349 1,213 14,594 700 12,750 605
2008 29,430 1,353 15,876 799 13,553 661
2007 24,825 1,158 13,078 611 11,706 627
2006 25,322 1,214 13,770 744 11,548 570

 

Chapter II, Table C2. [Rate of hospitalizations with all-listed alcohol-related diagnoses per 10,000 population]
All-listed alcohol-related diagnoses by year Total Sex
Male Female
Rate S.E. Rate S.E. Rate S.E.

SOURCE: Nationwide Inpatient Sample, 2006–2010.

Alcohol dependence syndrome

           
2010 38.9193 1.5701 58.1953 2.5058 20.5232 0.7973
2009 37.5341 1.5370 56.1576 2.4546 19.7723 0.7629
2008 35.9351 1.5719 52.9295 2.4145 19.7212 0.8724
2007 34.1958 1.3028 50.9085 2.0809 18.2372 0.6685
2006 34.1327 1.5301 51.1823 2.4453 17.8729 0.7304

Nondependent abuse of alcohol

           
2010 29.7252 1.0759 43.5165 1.6478 16.5391 0.5664
2009 27.1907 0.9753 39.7273 1.4884 15.2093 0.5211
2008 25.8219 0.9519 37.4854 1.4128 14.6822 0.5521
2007 27.1208 1.0380 39.5851 1.6258 15.2136 0.5244
2006 27.9529 1.1031 41.4221 1.7234 15.1053 0.5576

All chronic liver disease and cirrhosis

           
2010 32.7268 0.9281 39.1576 1.1736 26.5906 0.7448
2009 30.8699 0.9029 36.9785 1.0918 25.0416 0.7617
2008 28.6190 0.8898 34.3336 1.1090 23.1660 0.7154
2007 26.1018 0.6917 31.8155 0.9266 20.6488 0.5110
2006 25.2852 0.6910 30.8626 0.9055 19.9684 0.5328

Alcohol poisoning

           
2010 1.1451 0.0639 1.2900 0.0851 1.0068 0.0502
2009 1.0594 0.0470 1.1586 0.0556 0.9646 0.0458
2008 1.1507 0.0529 1.2723 0.0640 1.0349 0.0505
2007 0.9804 0.0457 1.0588 0.0495 0.9027 0.0484
2006 1.0103 0.0484 1.1264 0.0608 0.8994 0.0444

 

4.2. Co-occurrence of Alcohol-Related and Drug-Related ED Visits and Hospitalizations

Exhibit 2 lists the specific medical conditions and their associated ICD-9-CM codes that comprise the co-occurring drug-related diagnoses for alcohol-related ED visits and hospitalizations in this manual. These co-occurring drug-related diagnoses include drug psychoses, drug dependence, nondependent abuse of drugs, and poisoning by drugs and medicinal and biological substances. Relevant tables on this topic are Tables A5–A6, B5–B6, and C5–C6 in both chapters.

For example, Table A5 of Chapter I shows that among ED visits by patients ages 12–20 with a first-listed diagnosis of alcohol-related conditions in 2009, 10.4149 percent also had a drug-related diagnosis. The percentage increased in the 21–24 age group (11.7141) and the 25–44 age group (13.7157), then dropped in the 45–64 age group (9.2758) and was lowest (2.8101) in the 65+ age group.

 

Chapter I, Table A5. [Percent distribution that had co-occurring drug-related diagnoses among emergency department visits with first-listed alcohol-related diagnoses]
First-listed alcohol-related diagnoses
by co-occurring drug-related diagnoses and year
Age group
12–20 years 21–24 years 25–44 years 45–64 years 65+ years
Percent S.E. Percent S.E. Percent S.E. Percent S.E. Percent S.E.
SOURCE: Nationwide Emergency Department Sample, 2006–2010.

Any alcohol-related diagnoses

                   

     Any drug-related diagnoses

                   
2010 10.5599 0.4219 11.1513 0.4497 12.9930 0.4796 8.9504 0.4104 2.9796 0.1903
2009 10.4149 0.4110 11.7141 0.4572 13.7157 0.4964 9.2758 0.3398 2.8101 0.1973
2008 11.5120 0.4542 11.6685 0.5534 13.8112 0.5388 9.0148 0.3147 2.7641 0.1972
2007 11.3011 0.4901 12.3541 0.5488 15.1027 0.7752 9.4118 0.4104 2.5223 0.1728
2006 11.0244 0.3706 12.8177 0.5033 14.0358 0.3996 8.2116 0.2387 1.8994 0.1338

       Drug psychoses

                   
2010 0.2028 0.0376 0.5814 0.0782 1.0272 0.0760 0.8031 0.0561 0.4134 0.0540
2009 0.3198 0.0420 0.9691 0.1191 1.1103 0.0865 0.8716 0.0564 0.4617 0.1084
2008 0.2725 0.0455 0.6934 0.1006 1.0218 0.0971 0.8519 0.0697 0.5469 0.1122
2007 0.2793 0.0493 0.4792 0.0731 1.1079 0.1461 0.8046 0.0791 0.4145 0.0673
2006 0.2524 0.0396 0.4898 0.0632 0.9461 0.0908 0.7031 0.0471 0.3167 0.0539

       Drug dependence

                   
2010 0.6147 0.0743 1.5440 0.1532 3.0271 0.3357 2.4929 0.3389 0.8933 0.1186
2009 0.6473 0.0796 1.9478 0.1834 3.5266 0.3228 2.6302 0.2209 0.7518 0.1272
2008 0.8890 0.1582 1.7710 0.2155 3.4651 0.4248 2.5073 0.2763 0.6742 0.0812
2007 0.9954 0.1955 1.6613 0.1996 4.1473 0.7179 2.6390 0.3890 0.6474 0.1044
2006 0.5907 0.0695 1.5715 0.1590 2.8421 0.2019 1.7897 0.1136 0.4796 0.0648

 

Chapter II, Table C6. [Rate of hospitalizations with all-listed alcohol-related diagnoses that had co-occurring drug-related diagnoses per 10,000 population]
All-listed alcohol-related diagnoses by co-occurring drug-related diagnoses and year   Age group
  12–20 years   21–24 years   25–44 years   45–64 years   65+ years
  Rate   S.E.   Rate   S.E.   Rate   S.E.   Rate   S.E.   Rate   S.E.

— Less than or equal to 10 observations in the cell. SOURCE: Nationwide Inpatient Sample, 2006–2010.

Alcohol poisoning

                   

       Drug dependence

                   
2010 0.0261 0.0060 0.0823 0.0160 0.1164 0.0122 0.1041 0.0187          —          —
2009 0.0344 0.0077 0.0917 0.0177 0.1283 0.0140 0.0899 0.0126          —          —
2008 0.0341 0.0075 0.0740 0.0169 0.1193 0.0116 0.1046 0.0108          —          —
2007 0.0236 0.0059 0.0976 0.0183 0.0978 0.0100 0.0624 0.0071          —          —
2006 0.0204 0.0050 0.0729 0.0188 0.1239 0.0142 0.0683 0.0085          —          —

       Nondependent abuse of drugs

                   
2010 0.1286 0.0155 0.3691 0.0382 0.3489 0.0266 0.2711 0.0272 0.0208 0.0051
2009 0.1642 0.0169 0.3578 0.0356 0.3435 0.0223 0.2109 0.0163 0.0244 0.0059
2008 0.1613 0.0164 0.3379 0.0368 0.3636 0.0246 0.2254 0.0181          —          —
2007 0.1357 0.0165 0.3304 0.0368 0.3475 0.0267 0.1832 0.0160 0.0167 0.0059
2006 0.1665 0.0192 0.3255 0.0366 0.3216 0.0216 0.1742 0.0140 0.0188 0.0065

       Drug poisoning

                   
2010 0.3063 0.0256 0.9157 0.0673 1.1070 0.0564 0.8803 0.0446 0.1575 0.0168
2009 0.3239 0.0265 0.9448 0.0670 1.0884 0.0536 0.8350 0.0429 0.1625 0.0160
2008 0.3785 0.0292 1.0508 0.0764 1.2283 0.0632 0.9222 0.0504 0.1558 0.0153
2007 0.2941 0.0265 0.8655 0.0608 1.0441 0.0595 0.7257 0.0429 0.1636 0.0166
2006 0.3545 0.0281 0.9346 0.0699 1.0963 0.0605 0.7247 0.0398 0.1292 0.0147

 

Table C6 of Chapter II shows that in 2010, the rate of hospitalizations for patients ages 25 to 44 diagnosed with alcohol poisoning and a co-occurring drug poisoning was 1.1070 per 10,000 population. The exact number of these hospitalizations used as the numerator of this rate can be found in Table B6 of Chapter II, which shows that 9,102 hospitalizations in 2010 were among this group of inpatients. Note that in Tables B6 and C6, some of the values for the 65+ age group are suppressed and marked with a “–” symbol, because these cells had 10 or fewer patient records in the samples.

 

Chapter II, Table B6. [Number of hospitalizations with all-listed alcohol-related diagnoses that had co-occurring drug-related diagnoses]
All-listed alcohol-related diagnoses
by co-occurring drug-related diagnoses and year
Age group
12–20 years 21–24 years 25–44 years 45–64 years 65+ years
Number S.E. Number S.E. Number S.E. Number S.E. Number S.E.

— Less than or equal to 10 observations in the cell. SOURCE: Nationwide Inpatient Sample, 2006–2010.

Alcohol poisoning

                   

       Drug dependence

                   
2010 102 23 141 27 957 100 851 153           —          —
2009 134 30 156 30 1,054 115 722 101           —          —
2008 133 29 125 28 983 96 823 85           —          —
2007 92 23 164 31 807 83 481 55           —          —
2006 79 19 122 32 1,024 117 513 64           —          —

       Nondependent abuse of drugs

                   
2010 500 60 632 65 2,869 219 2,217 222 84 21
2009 641 66 608 61 2,824 183 1,693 131 97 23
2008 630 64 570 62 2,996 202 1,772 142           —          —
2007 529 64 556 62 2,867 220 1,412 124 63 22
2006 646 74 546 61 2,658 178 1,310 106 70 24

       Drug poisoning

                   
2010 1,191 100 1,567 115 9,102 464 7,199 365 637 68
2009 1,265 104 1,606 114 8,948 441 6,703 344 644 63
2008 1,479 114 1,773 129 10,121 521 7,250 396 604 59
2007 1,146 103 1,457 102 8,615 491 5,593 331 619 63
2006 1,376 109 1,569 117 9,060 500 5,451 299 480 55

 

4.3. Co-occurrence of Alcohol-Related and Mental Health-Related ED Visits and Hospitalizations

Exhibit 3 lists the specific medical conditions and their associated ICD-9-CM codes that comprise the co-occurring mental health-related diagnoses for alcohol-related ED visits and hospitalizations in this manual. These co-occurring mental health-related diagnoses include adjustment disorders, anxiety disorders, mood disorders, personality disorders, schizophrenia and other psychotic disorders, and all other mental disorders. Relevant tables on this topic are Tables A7–A8, B7–B8, and C7–C8.

Table A8 of Chapter II shows that in 2010, among hospitalizations of patients ages 12 and older, 46.6544 percent of those with an all-listed diagnosis of alcohol dependence syndrome also had a co-occurring mental health-related diagnosis. Notably, the percentage has increased from 41.3193 in 2006, and it was higher for females (60.4148 in 2010) than for males (41.5631 in 2010). Table B8 of Chapter II shows that in 2010, there were 307,489 hospitalizations of male patients ages 12 and older who had any alcohol dependence syndrome and any co-occurring mental health condition. The corresponding number for females was only 165,303.

 

Chapter II, Table A8. [Percent distribution that had co-occurring mental health-related diagnoses among hospitalizations with all-listed alcohol-related diagnoses]
All-listed alcohol-related diagnoses
by co-occurring mental health-related diagnoses and year
Total Sex
Male Female
Percent S.E. Percent S.E. Percent  S.E.

SOURCE: Nationwide Inpatient Sample, 2006–2010.

Alcohol dependence syndrome

           

     Any mental health-related diagnoses

           
2010 46.6544 0.8947 41.5631 0.8652 60.4148 0.8622
2009 46.3867 0.9253 41.1334 0.9010 60.6138 0.8710
2008 46.5773 1.1603 41.2822 1.1281 60.1322 1.0919
2007 42.5940 0.8667 37.4338 0.8256 56.3621 0.9034
2006 41.3193 1.0071 36.4255 0.9643 54.6981 1.0109

    Anxiety disorder

           
2010 10.9845 0.4003 9.0305 0.3348 16.2743 0.5439
2009 10.8263 0.4141 8.7645 0.3597 16.4127 0.5570
2008 10.0776 0.4454 8.2431 0.3773 14.7799 0.5990
2007 8.8600 0.3386 7.1467 0.2851 13.4314 0.4843
2006 7.9802 0.3401 6.5430 0.2798 11.9108 0.5075

     Depressive disorder

           
2010 25.2395 0.6450 22.0132 0.6173 33.9460 0.6538
2009 25.1998 0.6209 21.8199 0.6014 34.3562 0.6007
2008 25.2779 0.7726 21.8725 0.7210 33.9925 0.8402
2007 23.4403 0.5695 20.1554 0.5302 32.1994 0.6417
2006 22.3070 0.6762 19.0272 0.6238 31.2664 0.7349

 

Chapter II, Table B8. [Number of hospitalizations with all-listed alcohol-related diagnoses that had co-occurring mental health-related diagnoses]
All-listed alcohol-related diagnoses
by co-occurring mental health-related diagnoses and year
Total Sex
Male Female
Number S.E. Number S.E. Number S.E.

SOURCE: Nationwide Inpatient Sample, 2006–2010.

Alcohol dependence syndrome

           

     Any mental health-related diagnoses

           
2010 472,905 21,744 307,489 14,751 165,303 7,582
2009 449,451 20,298 290,971 13,596 158,415 7,184
2008 428,055 22,648 272,661 14,225 155,301 8,782
2007 368,807 17,009 235,394 11,438 133,304 6,041
2006 353,478 18,050 227,896 12,150 125,519 6,219

    Anxiety disorder

           
2010 111,342 5,496 66,809 3,209 44,529 2,429
2009 104,898 5,632 61,999 3,336 42,895 2,451
2008 92,616 5,649 54,444 3,136 38,172 2,639
2007 76,716 3,835 44,940 2,224 31,767 1,757
2006 68,269 3,780 40,936 2,273 27,333 1,639

     Depressive disorder

           
2010 255,836 11,348 162,857 7,451 92,881 4,177
2009 244,167 10,777 154,350 6,875 89,791 4,124
2008 232,309 12,623 144,464 7,613 87,791 5,263
2007 202,962 9,120 126,742 5,934 76,156 3,454
2006 190,831 9,266 119,044 5,901 71,749 3,532

 

Table C8 of Chapter II similarly shows that the corresponding rate for males was higher than that for females (24.1878 per 10,000 population versus 12.3990 per 10,000 population). Although Table A8 of Chapter II suggests that the co-occurrence of mental health conditions was more prevalent among females diagnosed with alcohol dependence syndrome than among their male counterparts, Tables B8 and C8 show a smaller number and a lower rate for females than for males. This was largely because fewer females (273,614) than males (739,813) were hospitalized for alcohol dependence syndrome, as shown in Table B2 of Chapter II.

 

Chapter II, Table C8. [Rate of hospitalizations with all-listed alcohol-related diagnoses that had co-occurring mental health-related diagnoses per 10,000 population]
All-listed alcohol-related diagnoses
by co-occurring mental health-related diagnoses and year
Total Sex
Male Female
Rate S.E. Rate S.E. Rate S.E.

SOURCE: Nationwide Inpatient Sample, 2006–2010.

Alcohol dependence syndrome

           

     Any mental health-related diagnoses

           
2010 18.1576 0.8349 24.1878 1.1603 12.3990 0.5687
2009 17.4108 0.7863 23.0996 1.0794 11.9847 0.5435
2008 16.7376 0.8856 21.8505 1.1400 11.8588 0.6706
2007 14.5654 0.6717 19.0570 0.9260 10.2789 0.4658
2006 14.1034 0.7202 18.6434 0.9940 9.7761 0.4844

    Anxiety disorder

           
2010 4.2751 0.2110 5.2553 0.2524 3.3400 0.1822
2009 4.0635 0.2182 4.9220 0.2648 3.2452 0.1854
2008 3.6214 0.2209 4.3630 0.2513 2.9148 0.2015
2007 3.0298 0.1515 3.6383 0.1800 2.4495 0.1355
2006 2.7239 0.1508 3.3489 0.1859 2.1288 0.1276

     Depressive disorder

           
2010 9.8230 0.4357 12.8107 0.5861 6.9668 0.3133
2009 9.4585 0.4175 12.2535 0.5458 6.7930 0.3120
2008 9.0837 0.4936 11.5770 0.6101 6.7037 0.4019
2007 8.0156 0.3602 10.2608 0.4804 5.8723 0.2663
2006 7.6140 0.3697 9.7386 0.4827 5.5882 0.2751

 

4.4. Co-occurrence of Alcohol-Related and Injury-Related ED Visits and Hospitalizations

Exhibit 4 lists the specific medical conditions and their associated ICD-9-CM codes that comprise the co-occurring injury-related diagnoses for alcohol-related ED visits and hospitalizations in this manual. These co-occurring injury-related diagnoses include unintentional injuries (such as falling, being struck by or against objects or persons, motor vehicle traffic, being cut or pierced, and being poisoned) and intentional injuries. Relevant tables on this topic are Tables A9–A10, B9–B10, and C9–C10 in both chapters. Portions of the selected tables are shown below as examples, in which certain numbers are boldfaced for illustration purposes.

For example, Table A10 of Chapter I shows that in 2010, among ED visits by patients ages 12–20, 28.9635 percent of those with an all-listed diagnosis of nondependent abuse of alcohol also had any injury-related diagnosis. The percentage increased in the 21–24 age group (38.7219), then dropped in the 25–44 and 45–64 age groups (30.3525 and 23.4314, respectively) and increased slightly in the 65+ age group (26.3012). Notably, the percentages of co-occurring injuries declined significantly between 2006 and 2010 for the two youngest groups (12–20 and 21–24) but remained almost unchanged for the older age groups.

In 2010, unintentional fall injury that co-occurred with nondependent abuse of alcohol among ED visits was most prevalent in the 65+ age group (18.3112 percent) and least prevalent in the 21–24 age group (5.0222 percent). By contrast, the co-occurring motor vehicle traffic injury was least prevalent in the 65+ age group (1.3144 percent) and most prevalent in the 21–24 age group (7.3974 percent), although the prevalence in the latter age group had decreased from 10.7162 percent in 2006.  

 

Chapter I, Table A10. [Percent distribution that had co-occurring injury-related diagnoses among emergency department visits with all-listed alcohol-related diagnoses]
All-listed alcohol-related diagnoses
by co-occurring injury-related diagnoses and year
Age group
12–20 years 21–24 years 25–44 years 45–64 years 65+ years
Percent S.E. Percent S.E. Percent S.E. Percent S.E. Percent S.E.

SOURCE: Nationwide Emergency Department Sample, 2006–2010.

Nondependent abuse of alcohol
                   

  Any injury-related diagnoses

                   
2010 28.9635 0.6097 38.7219 0.6426 30.3525 0.5083 23.4314 0.4390 26.3012 0.4173
2009 29.7761 0.5628 41.0545 0.6735 31.3989 0.5331 23.7447 0.4149 26.3597 0.4130
2008 30.5641 0.6163 41.5644 0.7319 32.4790 0.5735 24.1788 0.4161 26.7597 0.4662
2007 30.4140 0.6129 42.6934 0.6531 32.1494 0.5284 23.9188 0.3806 25.9390 0.4383
2006 32.7560 0.6001 44.5662 0.6746 31.6111 0.5913 23.5468 0.4247 26.0200 0.4452

    Unintentional Injuries

                   
2010 16.9575 0.4421 22.6701 0.5475 17.5930 0.3778 16.6448 0.3483 23.2976 0.4390
2009 16.9693 0.3980 23.8687 0.5590 17.9323 0.3795 16.6121 0.3218 23.2402 0.4169
2008 17.2035 0.4009 23.8847 0.5468 18.2744 0.3788 16.5421 0.3042 23.3224 0.4484
2007 17.4857 0.4909 24.8362 0.5908 17.9595 0.4255 16.0924 0.3654 22.2461 0.5038
2006 19.0759 0.4843 25.0840 0.5469 17.8484 0.3948 16.1161 0.3477 22.3990 0.4720

       Falls

                   
2010 5.0222 0.2042 6.8799 0.2073 6.0455 0.1339 9.0020 0.1845 18.3112 0.3711
2009 4.6174 0.1773 6.4886 0.2380 6.0311 0.1290 8.9033 0.1803 18.2889 0.3717
2008 4.5084 0.1802 6.5663 0.2412 5.6983 0.1210 8.5477 0.1620 18.2265 0.3776
2007 4.1950 0.1533 6.2412 0.2316 5.4252 0.1481 8.2080 0.1987 17.2390 0.4361
2006 4.4599 0.2157 5.9898 0.1984 5.3912 0.1493 8.2498 0.1947 17.5324 0.4145

       Motor vehicle traffic

                   
2010 4.9098 0.2369 7.3974 0.3423 4.5269 0.1879 2.1827 0.1037 1.3144 0.0935
2009 5.3253 0.2747 8.8442 0.4015 4.9741 0.2031 2.3859 0.1003 1.2216 0.0795
2008 5.7237 0.2360 8.8879 0.3677 5.5914 0.2096 2.6456 0.0953 1.4851 0.0801
2007 6.4302 0.2831 10.1499 0.4045 5.6323 0.2014 2.7217 0.1060 1.4601 0.0976
2006 7.5148 0.3181 10.7162 0.4165 5.6272 0.2214 2.7406 0.1080 1.4324 0.0966

 

Table C10 of Chapter I shows that in 2010, the population rate of ED visits by patients ages 21 to 24 who were diagnosed with any nondependent abuse of alcohol and co-occurring unintentional motor vehicle traffic injury was 6.8205 per 10,000 population, a decrease from 8.2799 per 10,000 population in 2006. The exact number of hospital discharges used as the numerator of this rate can be found in Table B10 of Chapter I, which shows that 11,671 ED visits in 2010 and 13,900 ED visits in 2006 were made by those ages 21 to 24 diagnosed with nondependent abuse of alcohol and co-occurring motor vehicle traffic injury.

 

Chapter I, Table C10. [Rate of emergency department visits with all-listed alcohol-related diagnoses that had co-occurring injury-related diagnoses per 100,000 population]
All-listed alcohol-related diagnoses by co-occurring injury-related diagnoses and year Age group
12–20 years 21–24 years 25–44 years 45–64 years 65+ years
Rate S.E. Rate S.E. Rate S.E. Rate S.E. Rate S.E.

SOURCE: Nationwide Emergency Department Sample, 2006–2010.

Nondependent abuse of alcohol

                   

  Any injury-related diagnoses

                   
2010 11.8894 0.4146 35.7022 1.2730 26.5042 0.8649 24.1977 0.7907 9.9134 0.3206
2009 11.9091 0.4300 35.7312 1.3983 25.7423 0.8743 22.1173 0.7480 9.2248 0.2827
2008 12.4306 0.5021 36.6091 1.5022 26.5899 0.9043 21.5722 0.7160 9.5195 0.3125
2007 12.1563 0.4474 35.1461 1.3123 25.3595 0.8739 19.9527 0.6396 8.9272 0.2946
2006 12.3883 0.4074 34.4340 1.1726 24.5317 0.7465 19.6269 0.6058 9.0737 0.2840

    Unintentional Injuries

                   
2010 6.9609 0.2596 20.9022 0.8075 15.3624 0.5313 17.1892 0.5880 8.7813 0.2962
2009 6.7869 0.2620 20.7738 0.8973 14.7018 0.5258 15.4735 0.5291 8.1331 0.2579
2008 6.9968 0.2858 21.0372 0.9042 14.9609 0.5038 14.7587 0.4856 8.2968 0.2766
2007 6.9890 0.2719 20.4457 0.8477 14.1665 0.5202 13.4241 0.4385 7.6563 0.2645
2006 7.2145 0.2710 19.3811 0.7355 13.8512 0.4391 13.4332 0.4354 7.8110 0.2583

       Falls

                   
2010 2.0616 0.1051 6.3434 0.2736 5.2790 0.1910 9.2964 0.3215 6.9018 0.2402
2009 1.8468 0.1011 5.6473 0.3051 4.9446 0.1832 8.2930 0.2897 6.4003 0.2142
2008 1.8336 0.1023 5.7835 0.3248 4.6651 0.1658 7.6262 0.2551 6.4839 0.2226
2007 1.6767 0.0796 5.1379 0.2736 4.2794 0.1654 6.8470 0.2348 5.9330 0.2200
2006 1.6867 0.1006 4.6280 0.2131 4.1838 0.1532 6.8764 0.2455 6.1139 0.2103

       Motor vehicle traffic

                   
2010 2.0155 0.1062 6.8205 0.3681 3.9530 0.1814 2.2541 0.1136 0.4954 0.0361
2009 2.1299 0.1175 7.6974 0.4243 4.0780 0.1951 2.2224 0.1068 0.4275 0.0287
2008 2.3279 0.1150 7.8283 0.4203 4.5776 0.1972 2.3604 0.0986 0.5283 0.0317
2007 2.5701 0.1226 8.3556 0.4089 4.4428 0.1912 2.2704 0.0961 0.5025 0.0342
2006 2.8421 0.1353 8.2799 0.3972 4.3670 0.1827 2.2843 0.0894 0.4995 0.0340

 

Chapter I, Table B10. [Number of emergency department visits with all-listed alcohol-related diagnoses that had co-occurring injury-related diagnoses per 100,000 population]
All-listed alcohol-related diagnoses by co-occurring injury-related diagnoses and year Age group
12–20 years 21–24 years 25–44 years 45–64 years 65+ years
Number S.E. Number S.E. Number S.E. Number S.E. Number S.E.

SOURCE: Nationwide Emergency Department Sample, 2006–2010.

Nondependent abuse of alcohol

                   

  Any injury-related diagnoses

                   
2010 46,236 1,612 61,091 2,178 217,940 7,112 197,888 6,467 40,087 1,296
2009 46,490 1,679 60,745 2,377 211,630 7,188 177,541 6,005 36,552 1,120
2008 48,568 1,962 61,787 2,535 219,101 7,451 169,595 5,629 36,915 1,212
2007 47,372 1,743 59,171 2,209 209,241 7,211 153,772 4,929 33,768 1,114
2006 48,099 1,582 57,808 1,969 202,728 6,169 147,626 4,557 33,722 1,055

    Unintentional Injuries

                   
2010 27,070 1,009 35,766 1,382 126,323 4,369 140,572 4,808 35,510 1,198
2009 26,494 1,023 35,316 1,526 120,865 4,322 124,210 4,247 32,226 1,022
2008 27,337 1,117 35,506 1,526 123,278 4,151 116,029 3,818 32,173 1,073
2007 27,235 1,060 34,422 1,427 116,887 4,292 103,457 3,380 28,960 1,001
2006 28,011 1,052 32,537 1,235 114,465 3,628 101,040 3,275 29,029 960

       Falls

                   
2010 8,017 409 10,854 468 43,408 1,570 76,026 2,629 27,909 971
2009 7,209 395 9,601 519 40,650 1,506 66,571 2,325 25,360 849
2008 7,164 400 9,761 548 38,440 1,366 59,955 2,006 25,143 863
2007 6,534 310 8,650 461 35,309 1,365 52,769 1,810 22,442 832
2006 6,549 391 7,769 358 34,575 1,266 51,722 1,847 22,722 782

       Motor vehicle traffic

                   
2010 7,838 413 11,671 630 32,505 1,492 18,434 929 2,003 146
2009 8,314 459 13,086 721 33,525 1,604 17,840 858 1,694 114
2008 9,095 449 13,212 709 37,719 1,625 18,557 775 2,049 123
2007 10,016 478 14,067 688 36,657 1,577 17,498 740 1,901 130
2006 11,035 525 13,900 667 36,088 1,510 17,182 673 1,856 126

4.5. Charge Estimates for Alcohol-Related ED Visits and Cost Estimates for Alcohol-Related Hospitalizations

Unlike the other topics covered in this manual showing the short trend data from 2006 to 2010, charge and cost estimates presented here are based on data from the most recent year, 2010. The charge data are available from both the NEDS and the NIS. However, the cost-to-charge ratios, necessary for converting charges to costs, are available only for the NIS and not for the NEDS. Consequently, cost estimates are presented for alcohol-related hospitalizations, whereas charge estimates rather than cost estimates are presented for alcohol-related ED visits. In general, costs are less than charges Costs tend to reflect the actual costs to produce hospital services. Charges represent the amount the hospital billed for the entire hospital stay (which does not include professional or physician fees). For each hospital, a hospital-wide cost-to-charge ratio is used, because detailed charges are not available across all HCUP states (Wier et al., 2011). A sizable proportion of ED visits and hospital stays have missing information on charges. To account for these cases where no charge data are recorded, the estimates of the aggregated charges or costs, as shown in Tables D1-2 and D2-2, are obtained by multiplying the numbers of all cases and the average charges or costs estimated from cases with valid charge or cost information. Essentially, this uses the average charges or costs based on known values to substitute for the charges or costs for cases where no charge data are recorded. Relevant tables on this topic are Tables D1-1, D1-2, D2-1, and D2-2.

Table D1-1 of Chapter II shows that in 2010, the median cost was $8,109 for males ages 12 and older who were hospitalized with the first-listed or principal diagnosis of alcohol-related conditions. The cost was $2,838 for females with the first-listed or principal diagnosis of nondependent abuse of alcohol. Table D2-2 of Chapter I shows that in 2010, the aggregate charges to patients ages 45 to 64 for their ED visits related to any alcohol-related diagnoses were $5,258.8 million, which was the highest among all age groups. Of these charges, $2,572.7 million was for ED visits related to nondependent abuse of alcohol, which was the highest among all alcohol-related diagnoses.

Chapter II, Table D1-1. [Median cost of hospitalizations with first-listed alcohol-related diagnoses]
First-listed alcohol-related diagnoses Total Sex
Male Female
Median S.E. Median S.E. Median S.E.

SOURCE: Nationwide Inpatient Sample, 2006–2010.

Any alcohol-related diagnoses

$4,182 $176 $4,091 $195 $4,416 $154

Alcoholic psychoses

$3,777 $195 $3,842 $209 $3,596 $179

Alcohol dependence syndrome

$3,194 $148 $3,168 $166 $3,318 $124

Nondependent abuse of alcohol

$2,942 $86 $2,985 $93 $2,838 $113

All chronic liver disease and cirrhosis

$8,104 $174 $8,109 $186 $8,095 $179

  Alcoholic liver disease

$8,059 $164 $8,043 $182 $8,101 $188

Alcohol poisoning

$4,829 $260 $5,002 $301 $4,510 $253

 

Chapter I, Table D2-2. [Total charge (in millions) of ED visits with all-listed alcohol-related diagnoses]
All-listed alcohol-related diagnoses Age group
  12–20 years   21–24 years   25–44 years   45–64 years   65+ years
  Sum   S.E.   Sum   S.E.   Sum   S.E.   Sum   S.E.   Sum   S.E.

SOURCE: Nationwide Emergency Department Sample, 2006–2010.

Any alcohol-related diagnoses

$500.4 $20.5 $592.1 $25.7 $3,615.2 $146.5 $5,285.8 $200.1 $1,189.5 $49.0

Alcoholic psychoses

$4.8 $0.5 $15.0 $1.1 $269.9 $12.4 $463.3 $20.0 $85.4 $4.2

Alcohol dependence syndrome

$41.6 $3.1 $83.6 $5.8 $925.0 $41.0 $1,651.5 $64.9 $300.5 $12.3

Nondependent abuse of alcohol

$421.8 $18.1 $462.8 $20.6 $2,188.4 $97.4 $2,572.7 $109.4 $447.2 $19.0

All chronic liver disease and cirrhosis

$27.4 $2.5 $43.0 $3.4 $637.5 $35.2 $1,528.0 $70.2 $503.2 $26.6

  Alcoholic liver disease

$0.5 $0.1 $3.9 $0.5 $171.8 $8.9 $517.3 $23.5 $97.7 $5.0

Alcohol poisoning

$18.6 $1.6 $14.3 $1.2 $60.8 $3.7 $50.6 $3.5 $6.2 $0.6

 

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