Alcohol-related social and health service use patterns as predictors of death and remission in patients with AUD

Abstract Aim This study examines the extent and continuity of alcohol-related social and health service utilization (HSU) of individuals with alcohol use disorder (AUD) and predicts longitudinal care outcomes in a prospective cohort study, by using electronic health records (EHR). In addition, use of mental health (MH) services is examined. Data and methods Data on alcohol-related social and health care visits and treatment periods were gathered from the EHR and municipal social service client databases in the North Karelia district of Finland, between 2011 and 2016 ( n  = 396). Results Institutional care (odds ratio [OR] 1.55), contact with MH nurse (OR 1.22), and visits to the primary health care (PHC) doctor for MH reasons (OR 1.89) were associated with increased odds of remission. Alcohol-related visits to the PHC doctor were associated with increased odds of death (OR 1.67). A high number of permanent diagnoses (OR 0.19), drunk driving incidences (OR 0.28), visits to specialized AUD doctor (OR 0.36), and visits to MH doctor (OR 0.50) decreased the odds of death. Conclusions Differences in HSU were identified according to the outcome status. MH-related visits were associated with achieving remission. Alcohol-related visits to PHC services were associated with an increased risk of death. Thus, the current capacity of PHC alone to address the care of patients with AUD seems insufficient. The integration of social and health services, access to specialized AUD care, and care coordination should be improved.