Excess costs of alcohol-dependent patients in German psychiatric care compared with matched non-alcohol-dependent individuals from the general population : a secondary analysis of two datasets

• Objectives Heavy alcohol use can cause somatic and mental diseases, affects patients' social life and is associated with social isolation, unemployment and reduced quality of life. Therefore, societal costs of alcohol dependence are expected to be high. The aim of this study was to estimate excess costs of patients with alcohol dependence diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria compared with individuals without alcohol dependence in Germany. Design In a secondary analysis, baseline data of patients with alcohol dependence enrolled in a randomised controlled trial (German Clinical Trials Register DRS00005035) were compared with data collected via a telephone survey from individuals without alcohol dependence and that had been matched by entropy balancing. Health service use was evaluated retrospectively for a 6-month period. Settings Four German psychiatric university clinics (patients with alcohol dependence) and the German general adult population (individuals without alcohol dependence). Participants n=236adult patients with alcohol dependence and n=4687adult individuals without alcohol dependence. Primary and secondary outcome measures The excess costs of health service use, absenteeism and unemployment of patients with alcohol dependence were calculated and compared with individuals without alcohol dependence. In subgroup analyses, the associations between excess cost and gender, comorbidities and the duration of disease were investigated. Results Total 6-month excess costs of Euro11839 (95% CI Euro11 529 to Euro12 147) were caused by direct excess costs of Euro4349 (95% CI Euro4129 to Euro4566) and indirect costs of Euro7490 (95% CI Euro5124 to Euro9856). In particular, costs of inpatient treatment, formal long-term care, absenteeism and unemployment were high. Conclusions Alcohol dependence causes substantial direct and indirect excess costs. Cost-effective interventions to prevent and treat alcohol dependence are urgently needed. Trial registration number DRKS00005035.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)

Nyckelord

excess costs

alcohol

economic burden

cost-of-illness

addiction treatment

economic evaluation

Publikations- och innehållstyp

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