Estimated cost of alcohol abuse to NHS in Tayside is a minimum of £15.1 million a year

31 January 2011

New research released by Marlyn Glen indicates that the estimated cost of alcohol abuse to the NHS in Tayside is a minimum of £15.1 million a year.

For four selected services, the figures were

*Ambulance service £2.73 million

* A&E attendances - £1.95 million

* outpatient attendances - £1.67 million

* beds occupied by those with alcohol-related conditions - £8.75 million

These estimates deal only with these four services and do not take account of the cost of alcohol abuse on :

* psychiatric bed use,

* prescribed drugs,

*laboratory testing.

Neither do they taking into account the number of GP consultations for alcohol abuse.

Commenting on the figures, Marlyn Glen said,

"There are no quick solutions to this long-standing public health problem .

"It is consuming vital NHS resources that could be directed elsewhere.

"There is already a great deal of a consensus on how alcohol abuse can be tackled through education and the enforcement of liquor laws.

"However the belief that the Scottish Government’s version of minimum pricing is a necessary solution to alcohol abuse is misplaced.

"People who have chosen not to abuse alcohol would find themselves penalised financially by having to pay more."

 


Estimating the costs of alcohol misuse to the NHS

Estimating the cost to the ambulance service

Parliamentary question

(1)Ambulance Service

Marlyn Glen :

To ask the Scottish Executive how many emergency incidents in the NHS Tayside area ambulances attended in 2009-10.

Nicola Sturgeon : There were 41,630 emergency ambulance incidents in the NHS Tayside area in 2009-10 and this includes all categories of response. This, and a range of other information related to the performance of the Scottish Ambulance Service, is published in their annual report.

 

Marlyn Glen :

To ask the Scottish Executive what the average cost was of an emergency ambulance call out in the East Central division of the Scottish Ambulance Service area in 2009-10.

Nicola Sturgeon : The average cost of an emergency ambulance in 2009-10 in East Central division of the Scottish Ambulance Service was £263.24. This, and a range of other information relating to the cost of ambulance activity, is published annually in the ISD Scotland Cost Book.

 

Scottish Government researchers estimate that 25 per cent of such incidents in Scotland are alcohol-related :

"3.13 Ambulance journeys: activity and cost data were obtained from Scottish Health Service Costs. Assuming that alcohol related costs were most likely to be associated with "road ambulances": there were 569,372 road ambulance incidents at a cost of £221.51 perincident. The original study, and the update in 2004, used an assumption of 12% of road ambulance incidents attributed to alcohol9. In light of the Strategy Unit assumption of 35%, a figure of 25% is used here with a cost estimate of £31.5m. This may still be an underestimate.2

 

So cost in 2009-10 = number of ambulance incidents x cost per incident x 25 per cent

= 41,630 x £263 x 25 per cent = £2.737 million

(2) Estimating the cost in Accident and Emergency attendances

Total number of attendances at

Ninewells in 2009-10 48,045

Perth Royal Infirmary in 2009-10 24,927

Total attendances at these core hospitals = 72,927

(Source : ISD Scotland)

Adding together the monthly totals produces the figure of 72,927.

Scottish Government researchers use an estimate of 25 per cent of all cases in Scotland being related to alcohol :

3.8

"A QIS report (2006)7 estimated that 11% of A&E attendances were alcohol related. This is at the lower end of estimates from various studies which have found rates of alcohol related attendance at A&E of between 4% and 46%. The Cabinet Office Strategy Unit suggested, from unpublished research commissioned by them, that up to 35% of all accident and emergency attendance and ambulance costs are alcohol related8. The figure of 11% seems likely to be an underestimate. If the proportion is nearer 46% the cost would be around £59m. A figure of 25%, at a cost of £32.3m, is used in these estimates, which is both more consistent with the Strategy Unit work and nearer the mid point of other studies.

The cost of these attendances in Tayside is number x cost of one incident x 25 per cent

= 72,972 x £107 x 25% = £1.95 million

 

(3) Outpatient appointments

The number of new outpatient appointments for NHS Tayside up to March 2010 was 132,747

(Source : ISD Scotland)

Parliamentary Question

Marlyn Glen :

To ask the Scottish Executive what the average cost was of a consultant outpatient attendance in 2009-10.

Nicola Sturgeon :

The average cost of a consultant outpatient attendance at an NHSScotland location in the financial year 2009-10 was £126.

Scottish Government researchers use a figure of 10 per cent if all cases in Scotland being related to alcohol

Out patient visits: 3.10 The number of OP visits associated with alcohol related disease (both direct and indirect) is estimated at 10%.

The total cost to the NHS in Tayside from alcohol abuse via new outpatient appointments is :

132,747 X £126 x 10 per cent = £1.67 million

 

(4) Estimating the cost from beds occupied by patients with alcohol-related conditions

Parliamentary question 

Marlyn Glen :

To ask the Scottish Executive what the average cost was of an acute occupied bed day in 2009-10.

(S3W-38841)

Ms Nicola Sturgeon :

The average cost of an acute occupied bed day in an NHSScotland hospital in the financial year 2009-10 was £595.

 

Marlyn Glen :

To ask the Scottish Executive how many acute occupied bed days in hospitals in NHS Tayside were directly connected with alcohol-related conditions in the last year for which information is available.

Shona Robison : Information on the number of acute occupied bed days which are directly attributable to alcohol-related conditions is not held centrally.

Information on acute occupied bed days is recorded on the SMR01 dataset. SMR01 has space for up to six diagnosis codes to be recorded, a main diagnosis and up to five secondary diagnoses. Alcohol-related problems will be recorded as either a main or a secondary diagnosis, so it is not possible to identify the cases where alcohol was directly attributed to the length of the admission.

Table 1 shows the total length of stay of patients treated in acute hospitals in NHS Tayside for alcohol-related conditions, recorded in any diagnosis position, 2008-09; the most recent year for which information is available. Due to the way alcohol-related conditions are recorded, it is not possible to determine whether the reason for admission is directly attributable to alcohol. Therefore this figure may be an overestimate.

Table 1: Total Length of Stay (Bed Days) of Patients Treated in General Acute Hospitals1,2 in NHS Tayside3 for Alcohol-Related Conditions4,5,6: 2008-09P

 

2008-09

NHS Tayside

14,075

 

The cost of alcohol misuse from the hospitalisation of those with alcohol -related conditions ( either a primary and secondary diagnosis ) to hospital bed resources in NHS Tayside in a year is estimated by :

number of occupied bed days x average cost of bed day

= 14,075 x £595 = £8.37 million


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