Impact of alcohol consumption upon medical care utilization and costs in men: 4-Year observation of National Health Insurance beneficiaries in Japan

Aims: The purpose of the present study was to examine the association between alcohol consumption and in-patient and out-patient care utilization and its costs, respectively. Design and participants: The present data were derived from a 4-year prospective observation of National Health Insurance beneficiaries in rural Japan. A total of 17 497 men aged 40-79 years were analysed, after excluding subjects who at the baseline reported having had at least one of four chronic diseases: stroke, myocardial infarction, liver disease and cancer. Alcohol intake was classified into five groups, not including ex-drinkers: life-long abstainers and ethanol intakes of 1-149 g/week, 150-299 g/week, 300-449 g/week, and ≥450 g/week. Findings: The hospital days and in-patient care cost showed a U-shaped relationship with alcohol consumption. In-patient cost was highest for those consuming more than 450 g/week [£74.96, 95% confidence interval (CI): 54.39, 95.52] and for life-long abstainers (£69.16, 95% CI: 62.08, 77.83), and lowest for those consuming 150-299 g/week (£51.69, 95% CI: 45.33, 58.04). Inpatient use by age specific analysis also showed a U-shape at all ages, and was lowest for those consuming 1-149 g/week in youngest age group. In contrast, the number of physician visits and out-patient cost showed an inverse linear relationships with alcohol consumption. Conclusions: This study suggests that in-patient use shows a U-shaped curve and out-patient use shows an inverse linear relationship to alcohol consumption.