{"doi":"10.1111/add.16771","title":"Association between change in alcohol use reported during routine healthcare screening and change in subsequent hospitalization: A retrospective cohort study","abstract":"BACKGROUND AND AIMS: Primary care systems often screen for unhealthy alcohol use with brief self-report tools such as the 3-item Alcohol Use Disorders Identification Test for consumption (AUDIT-C). There is little research examining whether change in alcohol use measured on the AUDIT-C captures meaningful change in outcomes affected by alcohol use. This study aimed to measure the association between change in AUDIT-C and change in all-cause hospitalization risk, measured in the year after each AUDIT-C. DESIGN: Retrospective cohort study. SETTING: Health system in the state of Washington, USA, that conducts annual screening with the AUDIT-C in outpatient care. PARTICIPANTS: Adults (n = 165 101) who had completed at least two AUDIT-Cs 11-24 months apart (2016-2020). MEASUREMENTS: AUDIT-C scores were grouped into five risk categories reflecting no drinking (0), drinking without unhealthy alcohol use [1-2 (female)/1-3 (male)] and unhealthy alcohol use with moderate risk [3-6 (female)/4-6 (male)], high risk (7-8), and very high risk (9-12). Changes in AUDIT-C were based on the number of category levels that changed (0-4). Hospitalizations were binary, reflecting one or more hospitalizations in the 365 days after each AUDIT-C, identified from insurance claims. FINDINGS: Of 165 101 eligible patients, 5.7% and 6.1% were hospitalized the year after the first and second AUDIT-C, respectively. Decreases in AUDIT-C risk category of 1 or ≥2 levels were associated with statistically significant decreases in risk of hospitalization, compared with the change in hospitalization risk for those with no change in AUDIT-C [1-level decrease: ratio of adjusted risk ratios (aRR) = 0.92, 95% confidence interval (CI) = 0.86-0.99; ≥2-level decrease: ratio of aRR = 0.68, 95% CI = 0.58-0.81]. Increases in AUDIT-C risk category of 1 or ≥2 levels were not associated with statistically significant differences in risk of hospitalization, compared with those with no change in AUDIT-C. CONCLUSIONS: A decrease in AUDIT-C score risk category is associated with a decreased risk of both all-cause hospitalizations and hospitalizations with conditions directly or potentially attributable to alcohol. An increase in AUDIT-C score does not appear to be associated with a change in risk of hospitalization in the following year.","journal":"Addiction","year":2025,"id":540193,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9617,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":974912,"name":"Douglas Berger","orcid":"0000-0002-8568-9163","position":1,"is_corresponding":false},{"id":275018,"name":"Jennifer F. Bobb","orcid":"0000-0002-4744-5897","position":2,"is_corresponding":false},{"id":311117,"name":"Malia Oliver","orcid":"0000-0002-8237-8028","position":3,"is_corresponding":false},{"id":311119,"name":"Katharine A. Bradley","orcid":"0000-0003-1933-4425","position":4,"is_corresponding":false},{"id":395933,"name":"Kevin A. Hallgren","orcid":"0000-0001-8386-3984","position":5,"is_corresponding":false},{"id":652184,"name":"Helen E. Jack","orcid":"0000-0003-2815-4725","position":0,"is_corresponding":true}],"reference_count":63,"raw_metadata":null,"created_at":"2026-07-19T02:52:38.861025Z","pmid":"39868613","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}