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Journal of General Internal Medicine

Erschienen in:

01.08.2015 | Original Research

Association Between Receipt of Brief Alcohol Intervention and Quality of Care among Veteran Outpatients with Unhealthy Alcohol Use

verfasst von: Joseph A. Simonetti, MD, MPH, Gwen T. Lapham, PhD, MPH, MSW, Emily C. Williams, PhD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 8/2015

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ABSTRACT

BACKGROUND

Brief alcohol intervention, including advice to reduce or abstain from drinking, is widely recommended for general medical outpatients with unhealthy alcohol use, but it is challenging to implement. Among other implementation challenges, providers report reluctance to deliver such interventions, citing concerns about negatively affecting their patient relationships.

OBJECTIVE

The purpose of this study was to determine whether patient-reported receipt of brief intervention was associated with patient-reported indicators of high-quality care among veteran outpatients with unhealthy alcohol use.

DESIGN

Cross-sectional secondary data analysis was performed using the Veterans Health Administration (VA) Survey of Healthcare Experiences of Patients (SHEP).

PARTICIPANTS

The study included veteran outpatients who (1) responded to the outpatient long-form SHEP (2009–2011), (2) screened positive for unhealthy alcohol use (Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) questionnaire score ≥ 3 for women, ≥ 4 for men), and (3) responded to questions assessing receipt of brief intervention and quality of care.

MAIN MEASURES

We used logistic regression models to estimate the adjusted predicted prevalence of reporting two indicators of high-quality care—patient ratings of their VA provider and of overall VA healthcare (range 0–10, dichotomized as ≥ 9 indicating high quality)—for both patients who did and did not report receipt of brief intervention (receiving alcohol-related advice from a provider) within the previous year.

KEY RESULTS

Among 10,612 eligible veterans, 43.8 % reported having received brief intervention, and 84.2 % and 79.1 % rated their quality of care as high from their provider and the VA healthcare system, respectively. In adjusted analyses, compared to veterans who reported receiving no brief intervention, a higher proportion of veterans reporting receipt of brief intervention rated the quality of healthcare from their provider (86.9 % vs. 82.0 %, p < 0.01) and the VA overall (82.7 % vs. 75.9 %, p < 0.01) as high.

CONCLUSIONS

In this cross-sectional analysis of veterans with unhealthy alcohol use, a higher proportion of those who reported receipt of brief intervention reported receiving high-quality care compared to those who reported having received no such intervention. These findings do not support provider concerns that delivering brief intervention adversely affects patients’ perceptions of care.

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Titel: Association Between Receipt of Brief Alcohol Intervention and Quality of Care among Veteran Outpatients with Unhealthy Alcohol Use
verfasst von: Joseph A. Simonetti, MD, MPH
Gwen T. Lapham, PhD, MPH, MSW
Emily C. Williams, PhD, MPH
Publikationsdatum: 01.08.2015
Verlag: Springer US
Erschienen in: Journal of General Internal Medicine / Ausgabe 8/2015
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-015-3218-5

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Association Between Receipt of Brief Alcohol Intervention and Quality of Care among Veteran Outpatients with Unhealthy Alcohol Use

ABSTRACT

BACKGROUND

OBJECTIVE

DESIGN

PARTICIPANTS

MAIN MEASURES

KEY RESULTS

CONCLUSIONS

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ABSTRACT

BACKGROUND

OBJECTIVE

DESIGN

PARTICIPANTS

MAIN MEASURES

KEY RESULTS

CONCLUSIONS

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