Why Are Some Male Alcohol Misuse Disorder Patients High Utilisers of Emergency Health Services? An Asian Qualitative Study

Pamela Goh, Lina Amirah Binte Md Amir Ali, Donovan Ou Yong, Gabriel Ong, Jane Quek, Halitha Banu, Jun Tian Wu, Charles Chia Meng Mak and Desmond Renhao Mao ()
Additional contact information
Pamela Goh: Home Team Behavioural Sciences Centre, Ministry of Home Affairs, Singapore 698928, Singapore
Lina Amirah Binte Md Amir Ali: Division of Advanced Internal Medicine, National University Hospital, Singapore 119074, Singapore
Donovan Ou Yong: Emergency Department, Tan Tock Seng Hospital, Singapore 308433, Singapore
Gabriel Ong: Home Team Behavioural Sciences Centre, Ministry of Home Affairs, Singapore 698928, Singapore
Jane Quek: Home Team Behavioural Sciences Centre, Ministry of Home Affairs, Singapore 698928, Singapore
Halitha Banu: Home Team Behavioural Sciences Centre, Ministry of Home Affairs, Singapore 698928, Singapore
Jun Tian Wu: Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117456, Singapore
Charles Chia Meng Mak: National Addictions Management Service, Institute of Mental Health, Singapore 539747, Singapore
Desmond Renhao Mao: Acute & Emergency Care Department, Khoo Teck Puat Hospital, Singapore 768828, Singapore

IJERPH, 2022, vol. 19, issue 17, 1-14

Abstract: Background: Certain alcohol misuse patients heavily utilise the Emergency Department (ED) and Emergency Medical Services (EMS) and may present with intoxication or long-term sequelae of alcohol misuse. Our study explored reasons for repeated ED/EMS utilisation and sought to understand perpetuating and protective factors for drinking. Methods: Face-to-face semi-structured qualitative interviews were conducted. Participants were recruited from an ED in Singapore. Interviews were audio-recorded, transcribed verbatim and underwent manual thematic analysis. Emergent themes were independently reviewed for agreement. Data from medical records, interview transcripts, and field notes were triangulated for analysis. Results: All participants were male ( n = 20) with an average age of 55.6 years ( SD = 8.86). Most were unemployed (75%), did not have tertiary education (75%), were divorced (55%), and had pre-existing psychiatric conditions (60%) and chronic cardiovascular conditions (75%). Reasons for utilisation included a perceived need due to symptoms, although sometimes it was bystanders who called the ambulance. ED/EMS was preferred due to the perceived higher quality and speed of care. Persistent drinking was attributed to social and environmental factors, and as a coping mechanism for stressors. Rehabilitation programs and meaningful activities reduced drinking tendencies. Conclusion: ED/EMS provide sought-after services for alcohol misuse patients, resulting in high utilisation. Social and medical intervention could improve drinking behaviours and decrease overall ED/EMS utilisation.

Keywords: alcohol misuse; emergency services; emergency department; repeated attendances; high utilization (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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