Abstract
IMPORTANCE: Unhealthy alcohol use contributes to a high rate of mortality. While alcohol use increased during the COVID-19 pandemic, recent trends in alcohol-related hospitalizations are unknown.
OBJECTIVE: To examine US trends in the rate and outcomes of alcohol-related hospitalizations from 2016 to 2022.
DESIGN, SETTING, AND PARTICIPANTS: This serial cross-sectional study examined hospitalizations among adults aged 18 years or older who were sampled in the National Inpatient Sample, weighted to reflect nationally representative estimates. Data were examined from April to October 2025.
MAIN OUTCOMES AND MEASURES: The primary outcome was alcohol-related hospitalizations, defined using discharge diagnosis codes. Hospitalizations were categorized as primary alcohol use disorder (AUD), primary alcohol-related medical complication, and secondary alcohol-related diagnosis based on discharge diagnosis codes. Secondary outcomes included in-hospital mortality, length of stay, cost of hospitalizations, and discharge disposition.
RESULTS: This study included a weighted 12 912 240 alcohol-related hospitalizations (age 50 to 64 years, 40.4% [95% CI, 40.3%-40.5%]; male, 71.5% [95% CI, 71.4%-71.6%]; Black, 15.6% [95% CI, 15.3%-15.9%]; Hispanic, 11.2% [95% CI, 10.9%-11.4%]; White, 64.9% [95% CI, 64.5%-65.3%]). From 2016 to 2022, the annual rate of alcohol-related hospitalizations per 100 000 remained stable from 721 in 2016 to 688 in 2022 (annual percentage change [APC], -0.43; 95% CI, -1.28 to 0.49) but increased from 70 to 83 among hospitalizations for alcohol-related medical complications (APC, 3.56; 95% CI, 2.19 to 4.94). Trends across demographic groups differed by reasons for hospitalization. In-hospital mortality increased from 2.4% (95% CI, 2.3% to 2.5%) in 2016 to 3.1% (95% CI, 3.0% to 3.2%) in 2022 (P < .001). Mean length of stay increased from 5.6 (95% CI, 5.6 to 5.7) to 6.2 (95% CI, 6.1 to 6.3) days (P < .001), and the rate of self-directed discharges increased from 5.0% (95% CI, 4.8% to 5.2%) to 6.3% (95% CI, 6.1% to 6.5%) (P < .001). Hospitalization costs increased even after accounting for inflation and amounted to $32.6 billion in 2022.
CONCLUSION AND RELEVANCE: In this serial cross-sectional study of nationally representative administrative data from 2016 and 2022, the rate of alcohol-related hospitalizations was stable while mortality, length of stay, and health care costs all increased. Preventive efforts are needed to improve outcomes and reduce health care spending by reducing population-level alcohol consumption and engaging patients in AUD treatment before progression to alcohol-related hospitalizations.