Alcohol-related hospital admissions have been rising steadily over the last decade or so, but the latest LAPE release suggests the effect of falling consumption since 2004 may now be beginning to show. Interpreting the data is however a rather complex issue, not just given variations amongst age groups and regions, but owing to the number of ways the data is recorded and measured.
The historical 'broad' measure of admissions, which includes a proportion of admissions that are linked to but not directly caused by alcohol (known as 'attributable fractions'), still increased overall - up by 1.3% in 2014/15. However in 2014 a change of focus to a new 'narrow' measure of alcohol-related admissions based on just alcohol-related primary diagnoses was introduced, reportedly to give a more sensitive representation of actual changes. Under the narrow measure, alcohol-related admissions fell by 0.7%, which PHE report as 'largely unchanged' on last year.
A stronger downward trend in alcohol-specific admissions in under 18's continued with an 8.6% fall in 2014/15, likely to reflect the more acute nature of younger people's admissions and falls in drinking amongst younger people. Admissions are also falling in the under 40's, but rising in the over 65's. An IAS blog post by Dr Tony Rao, a Consultant Old Age Psychiatrist, attributed this to the 'baby boomer' effect, with at least one-in-four alcohol-related admissions aged 65 and over.
Whilst overal rates of alcohol hospital admissions may be plateauing out, admissions specifically for alcoholic liver disease continue to rise - up 3.4% on last year and 33% up on 2008/09. This may reflect a longer lag effect than general alcohol-related admission rates, with advanced liver cirrhosis typically taking many years to develop.
A new measure of alcohol-related cancers has also been introduced, showing a gradual upward trend in the rate of alcohol-related tumours over the past decade, also likely to have a longer lag period than majority of alcohol-related conditions.
Less in the news?
Total alcohol-related admissions for England under the broad measure reached over one million in 2009/10 with subsequent annual releases generating widespread national media coverage. Indeed alcohol-related admissions had doubled in the period of 2003 - 2009 alone. This year some media reports mainly covered the increase in older people's admissions, whilst some local press in the North East picked up on it being the only region to have shown a significant decline of 5%. The North East though still has the highest rates in the country, which may be part of the reason why it may prove to be the first to set a future trend. The region also still has a dedicated alcohol office seeking to support effective alcohol strategy.
Complexities aside, a future downward trend in overall alcohol-related hospital admissions looks likely as the effect of many years of pre-2004 rising consumption wears off. However there are signs that the trend of overall declining alcohol consumption that began in 2004 may also be about to end. The forthcoming minimum unit pricing ruling could also prove to be another important development for the future of consumption and harm figures.
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