Artikel
■ Aims The study investigates to what extent changes in the numbers of hospital inpatients with an alcohol diagnosis can be used as an indicator of trends in alcohol-related harm in the Swedish population. ■ Data and Methods Changes in alcohol-related inpatient treatment are compared with trends in alcohol consumption and alcohol-related mortality between 1987 and 2003 by means of a graphical presentation and a correlation analysis. The data on alcohol-related inpatient treatment and alcohol-related mortality come from the Centre for Epidemiology at the Swedish National Board of Health and Welfare, and the data on alcohol consumption from both official statistics and survey studies. ■ Results Between 1987 and 1998, the number of patients with an alcohol diagnosis decreased although alcohol consumption and alcohol-related mortality remained relatively unchanged. After that, alcohol consumption has increased markedly. At the same time, the total number of patients treated has remained unchanged, whilst increases have occurred in the number of patients with an alcohol diagnosis in somatic inpatient treatment, in the proportion of patients with an alcohol diagnosis and in the number of patients with alcohol poisoning, liver disease or pancreatitis. At the same time, a decrease has occurred in the number of alcohol patients in psychiatry and the number of patients diagnosed with alcohol dependence. ■ Conclusion The total number of inpatients with an alcohol diagnosis should not be used as an indicator of changes in alcohol harm because the decreases in the number of patients in psychiatry seem to be due to the reorganisation of treatment, that is, reductions in bed places and a possible shift towards outpatient treatment. A more stable measure is the number of patients in somatic inpatient treatment, together with a few specific diagnoses, such as liver disease, pancreatitis and alcohol poisoning. A more complete picture of changes in alcohol-related harm in treatment, however, requires more information about the trends in outpatient treatment.