Medical Students’ Readiness for Cutbacks in Health Care Expenditures of Alcohol-Dependent Individuals: An Indicator for Stigmatization?

Background: Despite being affected by a severe disease with increased morbidity and mortality, alcohol-dependent individuals often experience stigmatizing situations in the health care system. This study aimed to investigate medical students’ attitudes towards alcoholism and their readiness for cutbacks in health care expenditures for alcohol-dependent individuals. Methods: In total, 2253 students of all federal states in Germany took part in this study. Attitudes towards alcoholism, sociodemographic variables, and motives for studying medicine were assessed with an online questionnaire. Students’ readiness for cutbacks in health care expenditures of alcohol-dependent individuals was measured in relation to the other diseases, including psychiatric conditions (e. g. depression, schizophrenia), potentially stigmatized non-psychiatric disorders (e. g. AIDS), and potentially lifestyle-related acute (e.g. myocardial infarction) or chronic (e. g. diabetes) conditions. Data were analyzed with hierarchical logistic regression models. Results: Compared to other medical and mental diseases, alcoholism was by far the most frequently chosen condition with a potential for financial savings. In multivariate analyses, the preference for cutbacks was associated with the increased wish for social distance, high internal attribution of responsibility, low perceived severity and personal vulnerability, the absence of alcoholism in participants’ social environment, and certain motives for studying medicine. Discussion: Since the majority of alcohol-dependent individuals avoid seeking addiction-specific help, physicians in primary care are often the only contact person in the health care system who can initiate health-related behavioral changes. However, persisting prejudges may affect the physician-patient-relationship and therapy adherence. Interventions aimed at reducing stigmatizing attitudes should be implemented at an early stage of medical education.