The costs of tobacco, alcohol and illicit drug abuse to Australian Society in 2004/05
Appendix C, Estimation of drug-attributable cases
Table of contents
- List of tables
- List of abbreviations
- Executive Summary
- Acknowledgments
- 1. Introduction
2. General methodological issues in the estimation of the social costs of drug abuse- 3. Availability of new or revised methodologies and data
- 4. The epidemiological background to economic studies
- 5. Estimation of drug-attributable crime costs
- 6. Some disaggregated costs 48
- 7. Aggregate results
- 8. Comparability with previous social cost estimates
- 9. Future research
- Bibliography
- Appendix A, Demographic estimates
- Appendix B, Drugs and crime: calculating attributable fractions from the DUMA and DUCO projects
- Appendix C, Estimation of drug-attributable cases
- Footnotes to appendices
This appendix was written by Associate Professor Jim Codde, School of Population Health, University of Western Australia.
Population data
Australian estimated resident population data for June 2004 used to calculate the drug-caused mortality rates shown in this report were obtained from the Australian Bureau of Statistics (ABS) publication Population by Age and Sex, Australian States and Territories, June 2005 (3201.0).Mortality data
Unit record level national mortality data for 2004 were obtained from ABS, Deaths, Australia, 2004 (3302.0). The total number of deaths registered in that year was 132,508. The causes of death for this data were coded using ICD-10. Alcohol-caused and tobacco-caused deaths were determined on the basis of the major cause of death codes but for many illicit drug-caused deaths, the additional causes of death data were used to determine the specific drug involved if possible.Morbidity data\
De-identified unit record level data for all public and private hospital discharges that occurred in Australia between 1 July 2004 and 30 June 2005 were obtained from the Australian Institute of Health and Welfare (AIHW) after receiving permission from all states and territories. All of the 7 million records were coded to ICD-10-AM (Third Edition) and grouped to ANDRG Version 4.2. Approximate cost of hospitalisation due to drug abuse was determined from the ANDRGs and the National Hospital Costing Data (Round 8, ANDRG 4.2) produced by the Commonwealth Department of Health and Ageing2.Top of Page
Estimation of drug-attributable cases
Conditions and diseases attributed to drug use are shown in Table 58 to Table 60 inclusive. Drug attributed cases were determined by multiplying these cases with an age-, sex- and condition-specific aetiologic fraction. The aetiologic fractions used in this report are largely based on the original work of English et al. (1995)3 and subsequently updated by Ridolfo and Stevenson (2001)4. While, on the whole, the relative risks of diseases associated with drug usage remained the same, for some diseases the aetiologic fractions in these two reports differed due to the use of more current drug usage prevalence data (1989 and 1995 respectively). For the purpose of this report, it was decided to update the aetiologic fractions once more where possible using even more current prevalence information. Furthermore, there was a desire to link more closely with the Australian Burden of Disease (ABOD) work being undertaken by the University of Queensland and the Australian Government Department of Health and Ageing.As such, a revised list of drug-related diseases and many of the aetiologic fractions cited in this report were based on a recent publication on the burden of disease and injury in Australia5. Due to a different focus, some drug-caused conditions were grouped into a broader category in the ABOD report. For the purposes of the current study, these diseases were more clearly identified as indicated in the following tables, which allows closer comparison with the work of English et al. (1995) and Ridolfo and Stevenson (2001).
On the whole, the alcohol aetiologic fractions derived for the ABOD report (Begg et al., 2007) were based on prevalence information from the 2001 National Health Survey6categorized into the four levels used by English et al., Ridolfo and Stevenson and the NHMRC’s recommendations on alcohol consumption. The relative risks and population attributable fractions were largely drawn from Ridolfo and Stevenson’s report. Due to the long lag time between exposure to tobacco smoke and the occurrence of cancer and chronic respiratory diseases, the proportion of disease attributable to smoking cannot be determined from current smoking prevalence. Consequently Begg et al. used a variety of techniques as outlined in their report. Similarly, determination of the aetiologic fractions associated with illicit drug use was based on a number of data sources that included the 2004 National Drug Strategy Household Survey7 and National Centre in HIV Epidemiology and Clinical Research8.
Table 61 to Table 67 inclusive show the sex- and age-specific aetiologic fractions for each drug-caused disease or condition. Unless stated to the contrary, these figures were obtained
or derived from the ABOD report or personal communications with the authors. Using these aetiologic fractions, the number of cases attributable to drug usage was determined. Based on the derived fraction of cases, the number of potential years of life lost was estimated from death data using the method of Hakulinen and Teppo (1976)9. Similarly, the drug-caused fraction of hospital separations, bed days and hospital costs were determined from the application of aetiologic fractions to the age and gender specific data.
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Table 58, Alcohol-caused conditions and defining ICD-10 codes
| Diseases and conditions | ICD-10 codes |
|---|---|
| Oropharyngeal cancer | C00-14 |
| Oesophageal cancer | C15 |
| Liver cancer | C22 |
| Laryngeal cancer | C32 |
| Female breast cancer | C50 |
| Alcoholic psychosis 10 | F10.3-10.9 |
| Alcohol dependence/abuse 9 | F10.0-10.2 |
| Alcoholic liver cirrhosis 9 | K70 |
| Road injuries | V01.1-01.9, V02.1-02.9, V03.1-03.9, V04.1-04.9, V06.1-06.9, V09.2-09.3, V10.4-10.9, V11.4-11.9, V12.4-12.9, V13.4-13.9, V14.4-14.9, V15.4-15.9, V16.4-16.9, V17.4-17.9, V18.4-18.9, V19.4-19.9, V20.4-20.9, V21.4-21.9, V22.4-22.9, V23.4-23.9, V24.4-24.9, V25.4-25.9, V26.4-26.9, V27.4-27.9, V28.4-28.9, V29.4-29.9, V30.5-30.9, V31.5-31.9, V32.5-32.9, V33.5-33.9, V34.5-34.9, V35.5-35.9, V36.5-36.9 ,V37.5-37.9, V38.5-38.9, V39.4-39.9, V40.5-40.9, V41.5-41.9, V42.5-42.9, V43.5-43.9, V44.5-44.9, V45.5-45.9, V46.5-46.9, V47.5-47.9, V48.5-48.9, V49.4-49.9, V50.5-50.9, V51.5-51.9, V52.5-52.9, V53.5-53.9, V54.5-54.9, V55.5-55.9, V56.5-56.9, V57.5-57.9, V58.5-58.9, V59.4-59.9, V60.5-60.9, V61.5-61.9, V62.5-62.9, V63.5-63.9, V64.5-64.9, V65.5-65.9, V66.5-66.9, V67.5-67.9, V68.5-68.9, V69.4-69.9, V70.5-70.9, V71.5-71.9, V72.5-72.9, V73.5-73.9, V74.5-74.9, V75.5-75.9, V76.5-76.9, V77.5-77.9, V78.5-78.9, V79.4-79.9, V80.3-80.5, V80.9, V81.1, V82.1-82.9, V83.0-83.3, V84.0-84.3, V85.0-85.3, V86.0-86.4, V87.0-87.8, V89.2, V89.9, Y85 |
| Alcoholic poly-neuropathy 9 | G62.1 |
| Hypertension | I11, I13.0, I15 |
| Ischaemic heart disease | I20-25 |
| Alcoholic cardiomyopathy 9 | I42.6 |
| Supraventricular cardiac dysrhythmias 9 | I47.1, I47.8-48.9 |
| Heart failure 9 | I50-51, I97.1 |
| Stroke - haemorrhagic/ ischaemic | G45, I60-69 |
| Oesophageal varicies 9 | I85, I98.2 |
| Gastro-oesophageal haemorrhage 9 | K22.6 |
| Alcoholic gastritis | K29.2 |
| Unspecified liver cirrhosis 9 | K74.3-74.6, K76.0, K76.9 |
| Cholelithiasis 9 | K80 |
| Pancreatitis - acute/chronic | K85, K86.0-86.1 |
| Alcoholic beverage & other EtOH poisoning 9 | X45 or Y15 & T51.0-51.1, T51.9 |
| Fall injuries | W00-19, M80-82 |
| Fire injuries | X00-19 |
| Drowning | W65-74 |
| Aspiration 9 | W78-79 |
| Diseases and conditions | ICD-10 codes |
|---|---|
| Occupational and machine injuries | V01.0, 02.0, V03.0, V04.0, V05, V06.0, V09.0-09.1, V09.9, V10.0-10.3, V11.0-11.3, V12.0-12.3, V13.0-13.3, V14.0-14.3, V15.0-15.3, V16.0-16.3, V17.0-17.3, V18.0-18.3, V19.0-19.3, V20.0-20.3, V21.0-21.3, V22.0-22.3, V23.0-23.3, V24.0-24.3, V25.0-25.3, V26.0-26.3, V27.0-27.3, V28.0-28.3, V29.0-29.3, V30.0-30.4, V31.0-31.4, V32.0-32.4, V33.0-33.4, V34.0-34.4, V35.0-35.4, V36.0-36.4, V37.0-37.4, V38.0-38.4, V39.0-39.3, V40.0-40.4, V41.0-41.4, V42.0-42.4, V43.0-43.4, V44.0-44.4, V45.0-45.4, V46.0-46.4, V47.0-47.4, V48.0-48.4, V49.0-49.3, V50.0-50.4, V51.0-51.4, V52.0-52.4, V53.0-53.4, V54.0-54.4, V55.0-55.4, V56.0-56.4, V57.0-57.4, V58.0-58.4, V59.0-59.3, V60.0-60.4, V61.0-61.4, V62.0-62.4, V63.0-63.4, V64.0-64.4, V65.0-65.4, V66.0-66.4, V67.0-67.4, V68.0-68.4, V69.0-69.3, V70.0-70.4, V71.0-71.4, V72.0-72.4, V73.0-73.4, V74.0-74.4, V75.0-75.4, V76.0-76.4, V77.0-77.4, V78.0-78.4, V79.0-79.3, V80.0-80.2, V80.6-80.8, V81.0, V81.2-81.9, V82.0, V83.4-83.9, V84.4-84.9, V85.4-85.9, V86.5-86.9, V87.9, V88, V89.0-89.1, V89.3, V90-99, X20-39, X50-58, W20-45, W49-60, W64, W75-99, Y40-84, Y86, Y88.0-88.3 |
| Suicide and self-inflicted injury | X60-84,Y87.0 |
| Child abuse 11 & Assault | X85-Y09, Y87.1 |
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Table 59, Tobacco-caused conditions and defining ICD-10 codes
| Diseases and conditions | ICD-10 codes |
|---|---|
| Oropharyngeal cancer | C00-14 |
| Oesophageal cancer | C15 |
| Stomach cancer | C16 |
| Pancreatic cancer | C25 |
| Laryngeal cancer | C32 |
| Lung cancer | C33-34 |
| Cervical cancer 12 | C53, D06 |
| Endometrial cancer (protective) | C54 |
| Bladder cancer | C67 |
| Kidney cancer | C64-66, C68 |
| Ischaemic heart disease | I20-25 |
| Chronic obstructive pulmonary disease | J40-44 |
| Tobacco abuse 13 | F17, T65.2, Z72.0 |
| Parkinson’s disease (protective) | G20-21 |
| Pulmonary circulation disease 12 | I26.0, I27-28 |
| Cardiac dysrhythmias 12 | I46-49 |
| Heart failure 12 | I50-51, I97.1 |
| Stroke | I60-69, G45 |
| Peripheral vascular disease | I70.0-I70.8, I72-74 |
| Lower respiratory tract infection | J10-13, J15-18, J20.0, J20.2-20.9, J21-22 |
| Crohn’s disease | K50 |
| Ulcerative colitis | K51 |
| Antepartum haemorrhage 11 | O20, O44.1, O45-46, P02.0-02.1 |
| Low birthweight | P05-07, P22 |
| SIDS | R95 |
| Fire injuries | X00-19 |
| Asthma (under 15 years) | J45-46 |
| Macular degeneration 14 | H35.3-52.4 |
| Otitis media 13 | H65-66 |
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Table 60, Illicit drug-caused conditions and defining ICD-10 codes
| Diseases and conditions | ICD-10 codes |
|---|---|
| Opiate dependence | F11.2-11.4 |
| Opiate abuse | F11.0-11.1 |
| Opiate poisoning | Y12 & T40.0-40.4* |
| Accidental opiate poisoning15 | X42 & T40.0-40.4* |
| Cannabis dependence | F12.2-12.4 |
| Cannabis abuse | F12.0-12.1 |
| Amphetamine dependence | F15.2-15.4 |
| Amphetamine abuse | F15.0-15.1 |
| Cocaine dependence | F14.2-14.4 |
| Cocaine abuse | F14.0-14.1 |
| Psychostimulant poisoning | Y11 & T43.6* |
| Accidental poison by psychostimulants 14 | X41 & T43.6* |
| Hallucinogen dependence | F16.2-16.4 |
| Hallucinogen abuse | F16.0-16.1 |
| Hallucinogen poisoning | Y12 & T40.8-40.9* |
| Other psychotropic drug poisoning | X42 & T40.5, T40.7* |
| Accidental poisoning by hallucinogens 14 | X42 & T40.8-40.9* |
| Anabolic steroid poisoning 16 | Y14 & T38.7* |
| Hepatitis B | B16, B17.0, B18.0-18.1 |
| Hepatitis C | B17.1, B18.2 |
| HIV/AIDS | B20-24, R75, Z20.6, Z21 |
| Infective endocarditis | I33 |
| Drug psychoses | F11.5-11.9, F12.5-12.9, F13.5-13.9, F14.5-14.9, F15.5-15.9, F16.5-16.9, F18.5-18.9, F19.5-19.9 |
| Maternal drug dependence 15 | O35.5 |
| Newborn drug toxicity 15 | P04.4, P96.1 |
| Antepartum haemorrhage | O20, O44.1, O45-46, O67, P02.0-02.1 |
| Low birth weight | P05-07, P22 |
| Road injuries | V01.1-01.9, V02.1-02.9, V03.1-03.9, V04.1-04.9, V06.1-06.9, V09.2-09.3, V10.4-10.9, V11.4-11.9, V12.4-12.9, V13.4-13.9, V14.4-14.9, V15.4-15.9, V16.4-16.9, V17.4-17.9, V18.4-18.9, V19.4-19.9, V20.4-20.9, V21.4-21.9, V22.4-22.9, V23.4-23.9, V24.4-24.9, V25.4-25.9, V26.4-26.9, V27.4-27.9, V28.4-28.9, V29.4-29.9, V30.5-30.9, V31.5-31.9, V32.5-32.9, V33.5-33.9, V34.5-34.9, V35.5-35.9, V36.5-36.9 ,V37.5-37.9, V38.5-38.9, V39.4-39.9, V40.5-40.9, V41.5-41.9, V42.5-42.9, V43.5-43.9, V44.5-44.9, V45.5-45.9, V46.5-46.9, V47.5-47.9, V48.5-48.9, V49.4-49.9, V50.5-50.9, V51.5-51.9, V52.5-52.9, V53.5-53.9, V54.5-54.9, V55.5-55.9, V56.5-56.9, V57.5-57.9, V58.5-58.9, V59.4-59.9, V60.5-60.9, V61.5-61.9, V62.5-62.9, V63.5-63.9, V64.5-64.9, V65.5-65.9, V66.5-66.9, V67.5-67.9, V68.5-68.9, V69.4-69.9, V70.5-70.9, V71.5-71.9, V72.5-72.9, V73.5-73.9, V74.5-74.9, V75.5-75.9, V76.5-76.9, V77.5-77.9, V78.5-78.9, V79.4-79.9, V80.3-80.5, V80.9, V81.1, V82.1-82.9, V83.0-83.3, V84.0-84.3, V85.0-85.3, V86.0-86.4, V87.0-87.8, V89.2, V89.9, Y85 |
| Suicide | X60-84, Y87.0 |
| Schizophrenia 17 | F20-29 |
Note: Conditions with a code marked with an asterisk examined all cause of death fields.
Tables 61 - 67 are avilable as a PDF file. (PDF 434 KB)
