RESUMEN
AIMS: This study is designed to determine the relative risk of mortality for white male problem drinkers compared to white males in the general population, and to identify any variation in relative risk of problem drinking in three age groups (18-29, 30-49 and 50-79 years). DESIGN: The research design is prospective, using historical administrative datasets from treatment programs in conjunction with vital records datasets. PARTICIPANTS: Participants include all white men aged 18-79 treated for alcohol-related problems in community mental health substance abuse programs in Vermont during 1991. The treatment group includes 1853 service recipients; the comparison group includes 196,443 adult white male residents of Vermont. MEASUREMENT: Measurement of mortality rates for problem drinkers was based on probabilistic determination of overlap between treatment and vital record datasets. FINDINGS: Mortality for problem drinkers is greater than the general population in all three age groups. The estimated relative risk of mortality in the oldest age group was lower than the other groups, but substantially higher than found in recently published research. The estimated relative risk of mortality in the youngest age group, which has rarely been addressed in previous research, was higher than the relative risk in the middle age group. CONCLUSION: The application of a public health research model in which problem drinkers are compared to the general population has potential to inform public policy. In this case, the public health approach identified an elevated risk of mortality associated with problem drinking among older adults that had not been evident in the previous research.
Asunto(s)
Trastornos Relacionados con Alcohol/mortalidad , Alcoholismo/mortalidad , Población Blanca/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Bases de Datos Factuales , Investigación sobre Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Riesgo , Vermont/epidemiologíaRESUMEN
Basic indicators of community support program treatment outcome as well as the degree to which the programs conform to practice guidelines for major depression are evaluated. Hospitalization rates subsequent to treatment are measured, and the correlation between hospitalization rates and practice patterns is determined. Data sets that describe outpatient and inpatient services over a 4-year period, but do not include common person identifiers were analyzed using probabilistic population estimates. Results indicate that there is substantial variation among the community programs in practice patterns and hospitalization rates, and the two are negatively correlated.