The fall in specialist admissions for alcohol withdrawal is associated with a rise in non-specialist admissions, say the authors of a study published in the journal Alcohol and Alcoholism.
The study examined the relationship between specialist and non-specialist admissions for alcohol withdrawal since the introduction of the UK government Health and Social Care Act in 2012.
Publicly available national data sets from 2009 to 2019 were used to compare the number of alcohol withdrawal admissions and estimated costs in specialist and non-specialist treatment settings.
The data demonstrated a significant negative correlation, providing strong evidence of an association between the fall in specialist and the rise in non-specialist admissions.
The percentage of adults accessing specialist admissions fell from 11.3 per cent in 2009-2010 to 5.8 per cent in 2018-2019. Before 2013-2014, the mean annual number of specialist admissions were relatively static. However, the mean annual number of specialist admissions decreased to 5453 admissions between 2013-2014 and 2018-2019, a reduction of 45.5 per cent.
Overall, annual specialist admissions decreased by a mean of 4559 (P=.01). By contrast, there was a 43.8 per cent increase in non-specialist admissions between 2009-2010 and 2018-2019, increasing by a mean of 4736 (P=.01).
The annual estimated total costs of specialist admissions reduced from £31.7 million to £15.9 million from 2009-2010 to 2018-2019, with a mean of £13.6 million per annum (41.3%; P=.01). In contrast, the estimated costs for non-specialist admissions increased by 67.3 per cent between 2009 and 2019, a mean increase of £16.3 million per annum (P=.01).
The estimated cost of each non-specialist admission was 29.8 per cent less than for specialist admissions. The overall cost per admission remained relatively unchanged from 2009-2010 to 2018-2019.
The authors say the shift in demand from specialist to non-specialist alcohol admissions should be reversed by specialist workforce investment to improve outcomes. In the meantime, they say, non-specialist services and staff must be resourced and equipped to meet the complex needs of these patients.
