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Managing alcohol-related attendances in emergency care: can diversion to bespoke services lessen the burden?
  1. Andy Irving1,
  2. Steve Goodacre1,
  3. Joanne Blake2,
  4. Davina Allen2,
  5. Simon C Moore3
  1. 1 Centre for Urgent and Emergency Care Research (CURE), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
  2. 2 School of Healthcare Sciences, Cardiff University, Cardiff, UK
  3. 3 School of Dentistry, Cardiff University, Cardiff, UK
  1. Correspondence to Professor Simon C Moore, School of Dentistry, Cardiff University, Cardiff CF14 4XY, UK; mooresc2{at}cardiff.ac.uk

Abstract

Acute alcohol intoxication (AAI) has a long history of burdening emergency care services. Healthcare systems around the world have explored a variety of different services that divert AAI away from EDs to better manage their condition. Little formal evaluation has been undertaken, particularly in the UK where alcohol misuse is one of the highest in the world. In this article, we outline a brief history of diversionary services, introduce the concept of Alcohol Intoxication Management Services (AIMS) and describe examples of AIMS in the UK. We then describe Evaluating the Diversion of Alcohol-Related Attendances, a natural experiment including six cities with AIMS compared with six cities without, that involves an ethnographic study, records patient experiences in both AIMS and EDs, assesses impact on key performance indicators in healthcare and evaluates the cost-effectiveness of AIMS.

  • alcohol abuse
  • emergency care systems
  • emergency departments
  • emergency department utilisation
  • prehospital care
  • clinical management

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Footnotes

  • Contributors The manuscript has been read and approved by all authors, the International Committee of Medical Journal Editors (ICMJE) criteria for authorship have been met and no person or persons other than the authors listed have contributed significantly to its preparation. The study formed part of the independent research by the National Institute for Health Research (HS&DR 14/04/25). The manuscript has not been submitted previously and is not under consideration for publication elsewhere. The authors have no commercial associations or sources of support that might pose a conflict of interest.

  • Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research Programme (project number 14/04/25). The views and opinions expressed there in are those of the authors and do not necessarily reflect those of the Health Service and Delivery Research Programme, NIHR, NHS or the Department of Health.

  • Competing interests None declared.

  • Ethics approval Wales research ethics committees.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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