Gual, AntoniLópez Pelayo, HugoBalcells Oliveró, Maria MercèOliveras, ClaraBruguera Soler, PolCordero Torres, ImanolMillán Hernández, AndreaPons-Cabrera, Maria TeresaGuzmán Cortez, Pablo RodrigoGómez-Ramiro, MartaVázquez, MireiaBorràs, RogerAsenjo Romero, MariaVieta i Pascual, Eduard, 1963-2025-11-132025-11-132024-12-032296-2565https://hdl.handle.net/2445/224365Introduction: Alcohol-related problems increase the probability of frequent emergency department (ED) use. In this study, we compared the direct healthcare expenses incurred during a single visit among frequent and non-frequent ED users and analyzed the impact of alcohol-related issues in healthcare costs arising from ED usage. Methods: The study relied on secondary analyses of economic data from a 1:1 matched case-control study with the primary aim of identifying the clinical characteristics of hospital ED frequent users in a Mediterranean European environment with a public, universal, and tax-funded health system. The participants ranged in age from 18 to 65 years and underwent ED visits at a high-complexity Spanish hospital (cases ≥5 times, controls <5) from December 2018 to November 2019. Each case was matched to a control with the same age, gender, and date of attendance at the ED. Clinical data and direct healthcare costs for a single ED visit were obtained by a retrospective review of the first electronic medical register. Costs and duration of stay were compared between cases and controls using paired-samples t-tests, and ED users with and without alcohol-related problems were compared using bivariate (independent-samples t-tests, one-way analysis of variance, Chi square tests, and multiple linear regression) and multivariate analyses (multiple linear regression models with backward stepwise selection algorithm, and dependent variable: total mean direct costs). Results: Among 609 case-control pairs (total n = 1218), mean total healthcare direct costs per ED visit were 22.2% higher among frequent compared with non-frequent users [mean difference 44.44 euros; 95% confidence interval (CI) 13.4-75.5; t(608) = 2.811; p = 0.005]. Multiple linear regression identified length of stay, triage level, ambulance arrival, and the specialty discharging the patient as associated with total healthcare costs for frequent users. In bivariate analyses, a history of alcohol-related problems was associated with a 32.5% higher mean total healthcare costs among frequent users [mean difference 72.61 euros; 95% confidence interval 25.24-119.97; t(320.016) = 3.015; p = 0.003]. Conclusion: The findings confirm the high cost of frequent ED use among people with alcohol-related problems, suggesting that costs could be reduced through implementation of intervention protocols.12 p.application/pdfengcc-by (c) Oliveras, C. et al., 2024http://creativecommons.org/licenses/by/4.0/AlcoholServeis d'urgències mèdiquesPsiquiatriaAlcoholEmergency medical servicesPsychiatryinfo:eu-repo/semantics/article7533192025-11-13info:eu-repo/semantics/openAccess