Alcoholic patients are less likely than sober patients to receive beta-blocker drugs when they were discharged from the hospital, but there were no other significant differences between treatment of the two groups, according to the Yale University School of Medicine study.
"Alcohol-related diagnoses are not a barrier to receiving most quality of care measures in elderly patients hospitalized" for heart attack, David Fiellin, M.D., of Yale University School of Medicine and colleagues said. "This finding speaks to the fact that there have been significant efforts across the board, in medicine in general, to monitor the provision of quality care."
Earlier studies had found that patients with mental disorders, including substance abuse, were less likely to get heart bypass procedures and angioplasty surgeries. Also a Canadian study showed that more than half of hospitals in North America who offer transplants use age as one of their criteria to screen out individuals for transplant.
But Fiellin and his colleagues studied data from 155,026 Medicare patients admitted to a hospital with a heart attack, age 65 and older, of which 1,284 were diagnosed with alcohol-related disorders.
Quality Heart Care Guidelines
With the exception of the beta-blockers, patients with an alcohol diagnosis fared no worse than their peers in terms of getting seven guidelines for heart attack treatment used by the researchers to determine quality care.Fiellin began the study feeling that elderly adults diagnosed with alcohol problems could be a "vulnerable population" that might receive substandard treatment. "I think that concern was that, as we know, patients who have mental health diagnoses can experience some level of stigma when they enter the health care system," Fiellin said.
Source: The study was published in the January 2005 issue of Alcoholism: Clinical & Experimental Research.
