{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:48:29Z","timestamp":1790858909223,"version":"4.1.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes for Health Research","doi-asserted-by":"crossref","award":["#293577"],"award-info":[{"award-number":["#293577"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Managed Alcohol Programs (MAPs) are designed to improve health and housing outcomes for unstably housed people with an alcohol use disorder (AUD). The present study assesses the association of MAP participation with healthcare and mortality outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective cohort study assessed health outcomes for 205 MAP participants and 128 controls recruited from five Canadian cities in 2006\u20132017. Survival and negative binomial regression models were used to calculate hazard ratios (HR) of death and emergency room (ER) visits and hospital bed days (HBDs). Covariates included age, sex, AUD severity and housing stability score.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In fully adjusted models, compared with times outside MAPs, participants had significantly reduced risk of mortality (HR\u2009=\u20090.37, P\u2009=\u20090.0001) and ER attendance (HR\u2009=\u20090.74, P\u2009=\u20090.0002), and fewer HBDs yearly (10.40 vs 20.08, P\u2009=\u20090.0184). Over the 12\u00a0years, people enrolled in a MAP at some point had significantly fewer HBDs per year than controls after MAP enrolment (12.78 vs 20.08, P\u2009=\u20090.0001) but not significantly different rates of death or ER presentation. MAP participants had significantly more alcohol-related but significantly fewer nonalcohol-related ER presentations than controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Attendance at a MAP was associated with reduced risk of mortality or morbidity and less hospital utilization for individuals with unstable housing and severe AUDs. MAPs are a promising approach to reduce mortality risk and time spent in hospital for people with an AUD and experiencing homelessness.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/alcalc\/agab078","type":"journal-article","created":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T04:38:44Z","timestamp":1636519124000},"page":"246-260","source":"Crossref","is-referenced-by-count":17,"title":["Participation in Canadian Managed Alcohol Programs and Associated Probabilities of Emergency Room Presentation, Hospitalization and Death: A Retrospective Cohort Study"],"prefix":"10.1093","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2166-5370","authenticated-orcid":false,"given":"Jinhui","family":"Zhao","sequence":"first","affiliation":[{"name":"University of Victoria, Canadian Institute for Substance Use Research (CISUR), 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5696-6803","authenticated-orcid":false,"given":"Tim","family":"Stockwell","sequence":"additional","affiliation":[{"name":"University of Victoria, Canadian Institute for Substance Use Research (CISUR), 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4845-1383","authenticated-orcid":false,"given":"Bernie","family":"Pauly","sequence":"additional","affiliation":[{"name":"University of Victoria, Canadian Institute for Substance Use Research (CISUR), 2300 McKenzie Ave, Victoria, BC V8N 5M8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1762-7021","authenticated-orcid":false,"given":"Ashley","family":"Wettlaufer","sequence":"additional","affiliation":[{"name":"Centre for Addiction & Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5040-727X","authenticated-orcid":false,"given":"Clifton","family":"Chow","sequence":"additional","affiliation":[{"name":"Vancouver Coastal Health Authority, 200-520 West 6th Avenue, Vancouver, BC V5Z 4H5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"2022031410500483600_ref1","volume-title":"Survival Analysis Using SAS: A Practical Guide","author":"Allison","year":"1995"},{"key":"2022031410500483600_ref2","volume-title":"Fixed Effects Regression Methods for Longitudinal Data Using SAS","author":"Allison","year":"2005"},{"key":"2022031410500483600_ref3","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1007\/s10464-011-9444-z","article-title":"Comparing the housing trajectories of different classes within a diverse homeless population","volume":"49","author":"Aubry","year":"2012","journal-title":"Am J Community Psychol"},{"key":"2022031410500483600_ref4","volume-title":"AUDIT-The Alcohol Use Disorders Identification Test Guidelines for Use in Primary Care","author":"Babor","year":"2001"},{"key":"2022031410500483600_ref5","doi-asserted-by":"crossref","first-page":"288","DOI":"10.17105\/SPR-2016-0004.V46-3","article-title":"Cyber victimization in high school: measurement, overlap with face-to-face victimization, and associations with social-emotional outcomes","volume":"46","author":"Brown","year":"2017","journal-title":"School Psychol Rev"},{"key":"2022031410500483600_ref6","volume-title":"Alcohol Related Disease Impact (ARDI) Application","author":"Centre for Disease Control and Prevention","year":"2013"},{"key":"2022031410500483600_ref7","doi-asserted-by":"crossref","first-page":"S167","DOI":"10.1111\/dar.12648","article-title":"Counting the cold ones: a comparison of methods measuring total alcohol consumption of managed alcohol program participants","volume":"37","author":"Chow","year":"2018","journal-title":"Drug Alcohol Rev"},{"key":"2022031410500483600_ref8","doi-asserted-by":"crossref","first-page":"S174","DOI":"10.1111\/dar.12649","article-title":"How do people with homelessness and alcohol dependence cope when alcohol is unaffordable? 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