[Economic aspect of alcohol-related disabilities in patients of gastroenterology and hepatology].

Alcoholic patients frequently visit a medical center with the alcohol-related organ damage. The medical utilization and expenses of these patients is not only for the treatment of alcohol dependence, but also mainly for the treatment of alcohol-related organ diseases. This study was conducted to clarify the influence of alcohol dependence on the medical expense of internal medicine, especially of gastroenterology and hepatology. Forty four patients who visited the department of gastroenterology and hepatology of our institute since November 2001 were included in the study. All of the patients were heavy drinkers and were suffered from alcohol damages in various organs. Medical expenses of these patients were calculated from the amount of the claim for health insurance system record of our hospital. Average cumulative number of the patients per month was 15.5 +/- 2.8 in out patient and 4.2 +/- 2.4 in hospitalized patient. Medical expenses in these patients, however, were lower in out patients than in hospitalized patients. Cumulative medical expense per month was 238,000 +/- 66,000 yen and 1,801,000 +/- 1,338,000 yen respectively. Alcoholic liver cirrhosis is one of the most frequently encountered disorder related to heavy drinking and needs hospitalization for the treatment of complications of this end stage liver disease. 13 patients (29.5%) were diagnosed as having alcoholic liver cirrhosis in this study. Some of the patients successfully abstained, but irreversible liver damage necessitated repeated hospitalization for the treatment of decompensated cirrhosis. As a result, cumulative medical expense per patient with alcoholic liver cirrhosis was significantly larger than those with noncirrhotic patient. These results suggest that abstinence from alcohol in early stage of alcoholic liver disease, before development of cirrhosis, is important from economic point of view.