1. Alcoholism In Italy: An Introductive Analysis Of Consumption
and Hospitalisation Trends
Aiello A1, D'Ausilio A1, Latorre E1, Toumi M2
1 Creativ Ceutical, Milano, Italy, 2 Aix-Marseille University, Marseille, France
BACKGROUND
Alcohol (beverage ethanol) distributes throughout the body, affecting almost all systems and altering nearly every neurochemical processes in the brain. Alcohol is likely to exacerbate most medical conditions and affects almost any medication metabolized in the liver (1).
This dependence is associated with high direct and indirect health care costs and the total costs attributable to alcohol abuse disorders represent a significant proportion of national health care spending in Europe (2-6).
A recent study from France has suggested that costs due to alcoholism correspond to ∼1% of the gross national product (7), while in Finland, direct health costs alone represent ∼0.6% of the gross domestic product, while total healthcare costs may reach 4.3% of the gross domestic product (8).
Such as for other European Mediterranean Countries, in Italy there is a regular consumption of alcohol with a large prevalence of daily drinkers who often consume alcohol with meals, but in the last years there has been a change in this custom (9).
The economic aspects of alcoholism have become increasingly important, due to rising healthcare costs for managing alcohol abuse consequences. Since health care resources are limited, the potential to reduce the alcohol condition incidence and progression as well as the cost of complications can produce important saving for the healthcare systems (10).
OBJECTIVES
The aim of this research is to analyse, between , alcohol consumption trends in Italy and the hospitalizations for acute alcoholic hepatitis, liver cirrhosis and alcoholic fatty liver.
We have also analysed the ratio between alcohol consumption and hospitalizations as well as hospital expenditures.
METHODS
Data on alcohol consumption from the National Institute of Statistics (ISTAT) and hospital discharge data from the Ministry of Health were matched to show hospitalisations trends in Italy.(11,12)
To estimate the hospitalization events, data for three DRGs (202, 205 and 206) directly related to alcohol abuse disease (acute alcoholic hepatitis, alcoholic liver cirrhosis and alcoholic fatty liver) were used.
Last published National DRGs Tariffs (year 2012) were used to estimate the cost of hospitalizations, in order to show difference in Italian healthcare expenditure in the selected period (13).
RESULTS
From 2009 to 2014 (Table 1, Figure 1), the percentage of daily alcohol consumers (DACs) on the general population decreased from 27.0% (14,419k) to 22.7% (12,020k). A slighter decrease of people with high risk habits of alcohol consumption (HRACs) from 15.8% (8,454k) to 15.2% (8,265k) was noticed. Then from 2012 an inversion in the trend can be observed (Table 1, Figure 1).
Considering hospitalizations related to liver alcohol habits in the analysed period (Table 1), a sharp decrease can be observed (from 82,713 to 59,124) and a ratio of hospitalizations can be estimated for DACs and HRACs: from 5.7‰ to 4,9‰ and from 9.8‰ to 7.2‰ respectively.
The total hospital costs related to liver disease are estimated to decrease from €262,281,276 to €193,907,144 (Figure 2).
Table 1. National alcohol consumption habits and hospital costs:
2009
2010
2011
2012
2013
2014
DACs
(% on POP)
14,419K (27.0%)
14,126K
(26.3%)
13,954K
(25.8%)
12,801K
(23.6%)
12,304K
(22.7%)
12,020K
(22.1%)
HRACs
8,454K (15.8%)
8,624K
(16.1%)
8,179K
(15.2%)
7,464K
(13.8%)
7,144K
(13.2%)
8,265K
HOSPs
82,713
78,817
72,941
67,916
63,097
59,124
HOSPs/DACs
5.7‰
5.6‰
5.2‰
5.3‰
5.1‰
4.9‰
HOSPs/HRACs
9.8‰
9.1‰
8.9‰
8.8‰
7.2‰
Legend: Daily Alcohol Consumers (DACs), High Risk Alcohol Consumers (HRACs),
Total Population (POP), Hospitalization Events (HOSPs).
Figure 1. National consumption habits (%) on the total population:
Legend: Daily Alcohol Consumers (DACs), High Risk Alcohol Consumers (HRACs).
Figure 2. Hospital Expenditure related to alcohol consumption:
CONCLUSIONS
The results of the analysis show a slight decrease in alcohol consumption which translated in a sharp decrease of hospitalizations for liver problems alcoholism-related though HRACs have increased in recent years.
Other causes should be scrutinized to confirm such results.
Should such results be established, it would be important to implement policies to reduce alcohol abuse to safeguard general health and save healthcare costs
REFERENCES
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4. Schädlich PK et al. Pharmacoeconomics. 1998;13: Brecht JG et al. Pharmacoeconomics. 1996;10: Holder HD et al. Adv Alcohol Subst Abuse.1986;6:1-15.
7. Reynaud M et al. Alcohol Alcohol. 2001;36: Hein R et al. Alcologia. 1999;11: Shield et al. Substance Abuse Treatment, Prevention, and Policy. 2013;8:21
10. Palmer AJ et al. Alcohol Alcohol. 2000;35: ISTAT. L’uso e l’abuso di alcol in Italia. Reports Ministero della Salute. I ricoveri in Italia. Reports
13. Ministero della Salute. Decreto
ISPOR 19th Annual European Congress 29 October- 2 November 2016 Austria Center Vienna, Vienna, Austria. PHS147