OBJECTIVES: In Singapore, the estimated prevalence of alcohol use disorder is 1.9%. However, the impact of excess alcohol consumption on healthcare resource utilization is poorly understood. We sought to assess temporal trends in alcohol-related hospitalizations, emergency visits, costs and mortality among Singaporean adults.

METHODS: We analyzed cross-sectional data of 7,580 Singaporeans admitted to Singapore General Hospital for alcohol use disorder, alcoholic liver disease or other alcohol-related medical problems from 2006 to 2016. Temporal trends in hospitalizations and emergency visits were assessed using Pearson correlation. We compared mean length of stay (LOS) and costs using linear regression. Annual proportion of inpatient mortality was compared using logistic regression. In addition, we compared mortality rates between alcohol-related diagnoses using Cox proportional hazards regression, with adjustments for age, gender and ethnicity.

RESULTS: From 2006 to 2016, the number of hospitalizations (883 to 841; p=0.071) and emergency visits (533 to 620; p=0.987) remained stable. There was a decrease in hospitalizations for alcohol use disorder (711 to 604; p=0.030) and an increase in emergency visits for alcoholic liver disease (38 to 70; p=0.004). Among those who were hospitalized, there was no significant change in mean LOS (6.7 ± 9.3 to 5.9 ± 15.3; p=0.392). There were significant increases in mean cost of hospitalization (S$5,460 ± S$8,385 to S$7,666 ± S$21,244; p=0.022) and emergency visits (S$235 ± S$68 to S$313 ± S$127; p<0.001) after adjusting for inflation. Inpatient mortality remained unchanged (3.9% to 3.3%; p=0.313). A total of 1,592 (21.0%) patients died during the study period. Mortality risk was higher among patients with alcoholic liver disease compared with those with alcohol use disorder (HR 1.73, 95% CI 1.52 – 1.96; p<0.001).

CONCLUSIONS: Over the past 11 years, the number alcohol-related hospitalizations and emergency visits remained stable. Inpatient mortality did not improve and costs of care have increased substantially.