Aims:

Alcohol use disorders (AUDs) are associated with high risk of comorbidities and excess use of social and healthcare services. We examined health service use (HSU) frequencies of patients with AUD in comparison to those with type 2 diabetes mellitus (T2DM).

Design:

A random sample of individuals with AUD (n = 396) were identified based on ICD-10 codes and HSU patterns, morbidity and mortality were compared with age- and gender-matched T2DM controls (n = 792) using logistic regression analysis. Six years (2011–2016) of electronic health record (EHR) data from the North Karelia district in Finland were used.

Results:

Similarities in comorbidity patterns existed, although mental health comorbidity (odds ratio [OR] 1.86) was more prevalent in the AUD group. The average annual HSU varied according to the groups: T2DM patients had more continuous contact with public health nurses in primary care, whereas AUD patients were more likely to experience somatic specialised care hospitalisations (OR 11.30) and have frequent somatic primary healthcare doctor visits (OR 3.30) and frequent emergency room doctor visits in specialised care (OR 8.89). Furthermore, patients with AUD had a 7.5 times higher risk of death compared with T2DM patients.

Conclusions:

This study identified rather similar comorbidity status for the AUD and T2DM patients, but their HSU patterns differed noticeably. AUD patients had higher frequencies of hospitalisation periods and emergency service use and were at a higher risk of death compared with T2DM patients, indicating greater challenges in the organisation of care for AUD patients compared with those having T2DM.

中文翻译：

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有酒精问题的人如何使用芬兰的社会和医疗服务？两个高需求患者群体之间的服务使用模式比较

目标：

酒精使用障碍 (AUD) 与合并症的高风险以及过度使用社会和医疗保健服务有关。我们比较了 AUD 患者与 2 型糖尿病 (T2DM) 患者的卫生服务使用 (HSU) 频率。

设计：

根据 ICD-10 代码和 HSU 模式确定了 AUD 个体的随机样本 ( n = 396)，使用逻辑回归分析将发病率和死亡率与年龄和性别匹配的 T2DM 对照 ( n = 792) 进行比较。使用了芬兰北卡累利阿区六年（2011-2016 年）的电子健康记录 (EHR) 数据。

结果：

合并症模式存在相似性，尽管在 AUD 组中精神健康合并症（优势比 [ OR ] 1.86）更为普遍。平均每年 HSU 因组而异：T2DM 患者与初级保健中的公共卫生护士有更多的持续接触，而 AUD 患者更有可能经历躯体专科住院治疗（OR 11.30）并经常就诊躯体初级保健医生（OR 3.30）和频繁的急诊室医生就诊（或8.89）。此外，AUD 患者的死亡风险是 T2DM 患者的 7.5 倍。

结论：

本研究发现 AUD 和 T2DM 患者的合并症状况非常相似，但他们的 HSU 模式明显不同。与 T2DM 患者相比，AUD 患者的住院时间和急诊服务使用频率更高，死亡风险更高，这表明与 T2DM 患者相比，AUD 患者的护理组织面临更大的挑战。