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

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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.

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Acknowledgments

This study was funded by the National Institute on Alcohol Abuse and Alcoholism grant no. 5R21AA015746. Preliminary findings from the study were presented at the annual conference of the American Public Health Association, 7 November 2007. The authors thank Grant Ritter, Ph.D., for statistical consultation and Michele Hutcheon for manuscript preparation.

Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

  1. Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Mail stop 035, 415 South St., Waltham, MA, 02454, USA

    Elizabeth L. Merrick PhD MSW, Dominic Hodgkin PhD, Deborah W. Garnick ScD, Constance M. Horgan ScD, Lee Panas MS & Marian Ryan RRT, MPH, CHES

  2. Boston University School of Medicine, Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center, Boston, MA, USA

    Richard Saitz MD, MPH

  3. Youth Alcohol Prevention Center, Boston University School of Public Health, Boston, MA, USA

    Richard Saitz MD, MPH

  4. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA

    Richard Saitz MD, MPH

  5. Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA

    Frederic C. Blow PhD

  6. Department of Veterans Affairs, Health Services Research and Development, Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI, USA

    Frederic C. Blow PhD

Authors
  1. Elizabeth L. Merrick PhD MSW
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  2. Dominic Hodgkin PhD
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  3. Deborah W. Garnick ScD
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  4. Constance M. Horgan ScD
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  5. Lee Panas MS
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  6. Marian Ryan RRT, MPH, CHES
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  7. Richard Saitz MD, MPH
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  8. Frederic C. Blow PhD
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Corresponding author

Correspondence to Elizabeth L. Merrick PhD MSW.

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Merrick, E.L., Hodgkin, D., Garnick, D.W. et al. Unhealthy Drinking Patterns and Receipt of Preventive Medical Services by Older Adults. J GEN INTERN MED 23, 1741–1748 (2008). https://doi.org/10.1007/s11606-008-0753-3

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  • DOI: https://doi.org/10.1007/s11606-008-0753-3

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