# Quality of Alcohol-Related Care Received: Missed Opportunities, Disparities and Impacts of Health Reform

> **NIH NIH P50** · PUBLIC HEALTH INSTITUTE · 2022 · $230,401

## Abstract

ABSTRACT: Quality of Alcohol-related Care Received: Missed Opportunities, Disparities and Impacts
 of Health Reform
Nearly 20 years ago it was estimated that Americans with an alcohol use disorder (AUD) receive recommended
care only 10% of the time. This was a striking, wake-up call to alcohol services providers and policymakers given
the tremendous impact of unchecked harmful drinking in the US. Excessive drinking is a leading cause of
preventable death among Americans, with 1 of every 4 US adults exceeding NIAAA's recommended drinking
limits. Moreover, there are disparities in on-going heavy drinking beyond young adulthood, in later onset,
persistence and recurrence of AUD, and in alcohol-related morbidity and mortality. The pressing need to address
unhealthy drinking has motivated alcohol screening and brief intervention (ASBI) in primary care, and recognition
of the chronic, relapsing nature of AUD has focused attention on treatment engagement, retention, and
completion and the promise of alcohol pharmacotherapy. Yet new research suggests that the quality of ASBI
falls far short of clinical guidelines, and that there may be disparities in access to pharmacotherapy. Now, more
than ever, healthcare quality and disparities are key issues for US healthcare providers and
policymakers, and targeted by health reform initiatives to improve patient outcomes and reduce medical costs.
This Continuing Center Project aims to shed light on these issues by using national survey and administrative
data to investigate alcohol-related care quality and disparities across the alcohol services system, from
prevention to treatment. Study Aims are to: 1) Assess the magnitude and severity of missed opportunities for
providing appropriate ASBI for unhealthy drinking and AUD; 2) Examine receipt of pharmacotherapy for AUD;
and 3) Assess the effects of health reform on the receipt of appropriate ASBI, completion of alcohol treatment,
and integrated care (receipt of specialty treatment and general health care by persons with AUD and especially
health comorbidities). This population-based study will leverage our team's distinctive expertise studying drinking
patterns, alcohol problems, alcohol services utilization and related disparities using national data sets; apply
traditional analytic and quasi-experimental techniques as well as cutting-edge causal inference methods; and
employ an integrative conceptual framework to highlight how inequities in care can add up across the alcohol
services system. By defining the need for care based on alcohol and health comorbidities, this study will highlight
the health implications of failing to provide quality care for unhealthy drinking and AUD. Findings can help to
stimulate efforts by clinicians, healthcare administrators, treatment providers and policymakers to increase and
improve alcohol-related care and equitable access.

## Key facts

- **NIH application ID:** 10359041
- **Project number:** 5P50AA005595-42
- **Recipient organization:** PUBLIC HEALTH INSTITUTE
- **Principal Investigator:** NINA MULIA
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $230,401
- **Award type:** 5
- **Project period:** 1981-07-01 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10359041

## Citation

> US National Institutes of Health, RePORTER application 10359041, Quality of Alcohol-Related Care Received: Missed Opportunities, Disparities and Impacts of Health Reform (5P50AA005595-42). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10359041. Licensed CC0.

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