Expenditures for Members of a Health Insurance Company Suffering from Alcoholism - A Payer's View

AIM In this study, expenditures of a health insurance company for alcoholics are calculated and analysed. METHOD Data are derived from the company's records. To participate in this study, subjects had to have a clearly alcohol-related diagnosis during a stay in hospital or a time-off work in 2001 (index-year). 127 Persons were identified according to these criteria. The sample was divided into two groups, those with an alcohol-related diagnosis only in 2001 (Group 1) and those with an alcohol-related diagnosis in at least one other year (Group 2, chronic condition). Expenditures are calculated, cost figures are compared with the health insurance company's average means. For Group 1, the course of costs is examined. Also, cost-predictors are identified. RESULTS The results show increased costs for alcoholics for all sectors included. Further analyses revealed higher expenditures for persons with a chronic condition (Group 2) and older age. The course of costs for Group 1 shows that expenditures here are clearly increased in the index-year, but not in the other years. CONCLUSIONS A recurrent diagnosis of alcoholism leads to high costs for health insurance companies. Investments in effective prevention and treatment strategies are recommended to reduce the financial burden.