In a community hospital, physicians identified with unusually high frequency (90%) the alcoholics they admitted to a medical-surgical service when life-style risk assessment was performed routinely. Identification rates were retrospectively evaluated based on chart documentation; 100 consecutive admissions receiving assessment interviews were compared with 100 consecutive admissions for a period 6 months later. During the screening period, plans addressing alcohol-related problems routinely appeared in the discharge summaries (71%), referral recommendations were frequently made for residential alcoholism treatment (52%), and intentions were stated to follow-up alcohol abuse problems in the office (43%). Decreases in these rates were observed when life-style risk assessment was not performed. Identification was made in 57% of patients; plans were stated concerning alcohol-related problems in 29%; residential referral was recommended in 5%; and office follow-up was arranged for 24%. The risk assessment program was economical and well received by the patients, the physician staff, and the hospital administration. No specialized program for physician education was utilized.
(Arch Intern Med. 1991;151:958-964)