Abstract
To our knowledge no previous studies have been conducted at the local authority level assessing relationships between alcohol-related hospital admission, specialist alcohol treatment provision and socioeconomic deprivation since the UK government passed the Health and Social Care Act in 2012. Our results, using publicly available national data-sets, suggest that the local authority areas in England most in need of adequately funded specialist alcohol treatment, because of high prevalence of alcohol dependence and deprivation, are not receiving targeted increased funding, and that the national rise in alcohol-related hospital admissions may be fuelled by local authority funding cuts to specialist alcohol treatment.
Highlights
The data suggest a mean decrease in net expenditure per 1000 people of £147 (3.81%) for alcohol misuse treatment and £88 (7.82%) for preventing and reducing alcohol misuse, per year
The increased rate of ‘broad’ hospital admissions per local authority was associated only with the reduction in net expenditure for alcohol misuse treatment per 1000 people for that local authority (β = −0.014; 95% CI −0.024 to −0.004; P = 0.01). This demonstrates that, if the average local authority reduced its net annual expenditure for treatment of alcohol misuse by 5%, we could expect to see an associated average increase of 60 ‘broad’ alcohol-related hospital admissions for that local authority per 100 000 people per year
Our results show similar patterns to individual-level data observed since the passage of the HSCA, indicating on average year-on-year increases in alcohol-related hospital admissions and concomitant year-on-year reductions in both the number of people entering specialist treatment and net local authority expenditure for treatment of alcohol misuse.[1,2]
Summary
Annual estimates for nine metrics were extracted from publicly available data sources for each of the 152 local authorities in England (Table 1). These metrics represent official local authority-level measures of specialist treatment access, treatment success and treatment funding, alcohol-related hospital admissions, alcohol disease burden and socioeconomic deprivation. Data were extracted for the previous six financial years for which local authorities have had complete control of drug and alcohol service commissioning (2013–2014 to 2018–2019), with 2013–2014 taken as the baseline for comparison. We took 2016–2017 as the baseline for expenditure data. All expenditure data were adjusted for inflation using the UK gross domestic product (GDP) deflator.[6]
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