Trends in alcohol-attributable hospitalisations and emergency department visits by age, sex, drinking group and health condition in Ontario, Canada

Abstract

Introduction: Alcohol-attributable harms are increasing in Canada. We described trends in alcohol-attributable hospitalisations and emergency department (ED) visits by age, sex, drinking group, attribution and health condition. Methods: Hospitalisation and ED visits for partially or wholly alcohol-attributable health conditions by age and sex were obtained from population-based health administrative data for individuals aged 15+ in Ontario, Canada. Population-level alcohol exposure was estimated using per capita alcohol sales and alcohol use data. We estimated the number and rate of alcohol-attributable hospitalisations (2008–2018) and ED visits (2008–2019) using the International Model of Alcohol Harms and Policies (InterMAHP). Results: Over the study period, the modelled rates of alcohol-attributable health-care encounters were higher in males, but increased faster in females. Specifically, rates of alcohol-attributable hospitalisations and ED visits increased by 300% (19–76 per 100,000) and 37% (774–1,064 per 100,000) in females, compared to 20% (322–386 per 100,000) and 2% (2563–2626 per 100,000) in males, respectively. Alcohol-attributable ED visit rates were highest among individuals aged 15–34, however, increased faster among individuals aged 65+ (females: 266%; males: 44%) than 15–34 years (females:+17%; males: −16%). High-volume drinkers had the highest rates of alcohol-attributable health-care encounters; yet, low-/medium-volume drinkers contributed substantial hospitalisations (11%) and ED visits (36%), with increasing rates of ED visits in females drinking low/medium volumes. Discussion and Conclusions: Alcohol-attributable health-care encounters increased overall, and faster among females, adults aged 65+ and low-/medium-volume drinkers. Monitoring trends across subpopulations is imperative to inform equitable interventions to mitigate alcohol-attributable harms.