Trauma surgeons back alcohol programs

Injured patients with alcohol problems would get screenings and intervention more often if there were no insurance roadblocks, a study said.

By Damon Adams, AMNews staff. Dec. 5, 2005.

Trauma surgeons would be willing to establish alcohol intervention programs at trauma centers if there were no insurance barriers for patients who consumed alcohol.

A new study found that most trauma surgeons and state legislators believe that trauma centers should screen patients for alcohol and drug use and offer counseling to those who screen positive. But surgeons apparently are reluctant to do that, because one in four of the 98 surgeons surveyed nationwide had been denied insurance payment because drug or alcohol use was documented, according to the study in the September issue of the Journal of Trauma Injury, Infection, and Critical Care.

The Uniform Accident and Sickness Policy Provision Law, a model law that more than two dozen states have adopted, allows insurers to exclude coverage for alcohol- and drug-related injuries. Most trauma surgeons did not know that UPPL statutes existed in their states. Although surgeons lacked knowledge of state law, some did experience alcohol-related insurance denials, the study said.

The denials appear to affect screening practices. Only about half of the surgeons routinely measure blood alcohol concentration, even though 91% of them said it is important to determine that about a patient.

Screening injured patients for an alcohol problem and providing a brief intervention can reduce subsequent alcohol use and hospital readmissions, the study said. The majority of trauma centers do not provide such screening and intervention.