Journal of General Internal Medicine

, 23:1741

Unhealthy Drinking Patterns and Receipt of Preventive Medical Services by Older Adults

Authors

    • Institute for Behavioral Health, Heller School for Social Policy and ManagementBrandeis University
  • Dominic Hodgkin
    • Institute for Behavioral Health, Heller School for Social Policy and ManagementBrandeis University
  • Deborah W. Garnick
    • Institute for Behavioral Health, Heller School for Social Policy and ManagementBrandeis University
  • Constance M. Horgan
    • Institute for Behavioral Health, Heller School for Social Policy and ManagementBrandeis University
  • Lee Panas
    • Institute for Behavioral Health, Heller School for Social Policy and ManagementBrandeis University
  • Marian Ryan
    • Institute for Behavioral Health, Heller School for Social Policy and ManagementBrandeis University
  • Richard Saitz
    • Boston University School of Medicine, Clinical Addiction Research and Education (CARE) Unit, Section of General Internal MedicineBoston Medical Center
    • Youth Alcohol Prevention CenterBoston University School of Public Health
    • Department of EpidemiologyBoston University School of Public Health
  • Frederic C. Blow
    • Department of PsychiatryUniversity of Michigan
    • Department of Veterans Affairs, Health Services Research and DevelopmentSerious Mental Illness Treatment Research and Evaluation Center
Original Article

DOI: 10.1007/s11606-008-0753-3

Cite this article as:
Merrick, E.L., Hodgkin, D., Garnick, D.W. et al. J GEN INTERN MED (2008) 23: 1741. doi:10.1007/s11606-008-0753-3

Abstract

Background

Preventive service use among older adults is suboptimal. Unhealthy drinking may constitute a risk factor for failure to receive these services.

Objectives

To determine the relationship between unhealthy drinking and receipt of recommended preventive services among elderly Medicare beneficiaries, applying the framework of current alcohol consumption guidelines.

Design/Methods

The data source is the nationally representative 2003 Medicare Current Beneficiary Survey. The sample included community-dwelling, fee-for-service Medicare beneficiaries 65 years and older (N = 10,523). Based on self-reported drinking, respondents were categorized as nondrinkers, within-guidelines drinkers, exceeding monthly but not daily limits, or heavy episodic drinkers. Using survey and claims data, influenza vaccination, pneumonia vaccination, glaucoma screening, and mammogram receipt were determined. Bivariate and logistic regression analyses were conducted.

Results

Overall, 70.3% received flu vaccination and 49% received glaucoma screening during the year, 66.8% received pneumonia vaccination, and 56.2% of women received a mammogram over 2 years. In logistic regression, heavy episodic drinking was associated with lower likelihood of service receipt compared to drinking within guidelines: flu vaccination (OR 0.75, CI 0.59–0.96), glaucoma screening (OR 0.74, CI 0.58–0.95), and pneumonia vaccination (OR 0.75, CI 0.59–0.96). Nondrinkers when compared with those reporting drinking within guidelines were less likely to receive a mammogram (OR 0.83, CI 0.69–1.00).

Conclusions

Heavy episodic drinking is associated with lower likelihood of receiving several preventive services. Practitioners should be encouraged to screen all elders regarding alcohol intake and in addition to appropriate intervention, consider elders reporting heavy episodic drinking at higher risk for non-receipt of preventive services.

KEY WORDS

unhealthy drinkingMedicare beneficiariespreventive servicesolder adults

Copyright information

© Society of General Internal Medicine 2008