The Impact of Alcohol Restriction on Hospital and Emergency Department Service Utilizations in Two Remote Towns in the Kimberley Region of Western Australia.

Wenxing Sun,Peter Somerford,Jianguo Xiao,Le Jian,Grant Akesson

doi:10.3389/fpubh.2019.00017

Abstract

Background: In a remote region of Western Australia, Kimberley, residents have nearly twice the State average per capita consumption of alcohol, four and a half times the level of alcohol-related hospitalizations and nearly three times the level of alcohol-related deaths. This study aimed to evaluate the long term effects of alcohol sale restrictions on health service utilization in two remote towns in Kimberley.Methods: Sale of high strength packaged alcohol was restricted in Fitzroy Crossing and Halls Creek since October 2007 and May 2009, respectively. Alcohol-related Emergency Department (ED) attendances and hospitalizations utilized by local residents before and after the intervention between 2003 and 2013 was compared by using yearly rates (/1,000 person-years) and interrupted time series analysis with Autoregressive Integrated Moving Average (ARIMA) modeling. The Western Australia specific aetiological fractions (AAFs) were applied to hospital inpatient data for estimation of the proportion of hospital separations attributable to alcohol.Results: In Fitzroy Crossing, there was a significant reduction of over 40% on rates (/1,000 person-years) of alcohol-related acute hospitalizations (54.2 [95% CI: 53.8–54.7] vs. 31.7 [31.4–32.1]) and ED attendances (534.1[532.8–535.5] vs. 294.5 [293.5–295.4]). In Halls Creek, there was a significant reduction of over 50% on rates (/1,000 person-years) of alcohol- related acute hospitalizations (17.7 [17.6–17.8] vs. 8.0 [7.9–8.1]) and ED attendance (248.4 [247.9–248.9] vs. 111.1[110.8–111.5]). Domestic violence and injury related hospitalization rates were also reduced by over 20% in both towns.Conclusions: The total restriction of selling high strength alcohol through a community driven process has shown to be effective in reducing alcohol-related health service utilization in post-intervention period. Continue monitoring is required to address new emerging issues. Future research on health service utilization related to alcohol by using interrupted time series analysis incorporating ARIMA modeling and applying AAFs are recommended for evaluating alcohol-related interventions.

Highlights

The misuse of alcohol is a major cause of injuries, domestic violence, chronic diseases and deaths worldwide, accounting for nearly 10% of global deaths among people aged 15–49 years [1]
This study has demonstrated the positive effect of community driven alcohol sale restriction on health service utilization in Fitzroy Crossing and Halls Creek, two remote towns of Western Australia (WA)
This study was a retrospective evaluation of an intervention which was implemented at a clear time point by using the interrupted time series analysis

Summary

Introduction

The misuse of alcohol is a major cause of injuries, domestic violence, chronic diseases and deaths worldwide, accounting for nearly 10% of global deaths among people aged 15–49 years [1]. With 26% of Indigenous population, Northern Territory of Australia has the second highest alcohol consumption per capita in the world, estimated 15.1 L of pure alcohol per year [7]. The Kimberley Health Region, defined by the Department of Health Western Australia (WA), is the northernmost region of WA. The Kimberley region has nearly twice the State average per capita consumption of alcohol, four and a half times the level of alcohol-related hospitalizations and nearly three times the level of alcohol-related deaths [8, 9]. In a remote region of Western Australia, Kimberley, residents have nearly twice the State average per capita consumption of alcohol, four and a half times the level of alcohol-related hospitalizations and nearly three times the level of alcohol-related deaths.

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