Effect of health service integration on the health care use of patients with alcohol use disorders in North Karelia Finland 2016-2020: A comparative cross-sectional study

Background: In North Karelia, Finland, a comprehensive integration of health and social services was implemented in 2017. This study sought to evaluate the impact of integration on the utilisation of health services among patients with alcohol use disorders (AUDs). Methods: Data from 2016 to 2020 were gathered from the electronic health records, encompassing both primary and specialised care, for patients with AUDs (n = 4344). Patients were identified based on AUD-related International Statistical Classification of Diseases and Related Health Problems (ICD-10) diagnosis codes. The data included information on the type of contact, reason for contact (ICD-10 code), and professional providing the service. Results: The proportion of patients with any annual contact with health services was approximately 90%, and this proportion remained unaffected by the integration. Decreases in AUD contacts were noted across the entire patient cohort, except for those diagnosed with AUD already in 2016. Emergency care use increased among patients treated in substance abuse services after the integration of services. Remote online and telehealth contacts increased across service domains, but these changes were unrelated to the integration year. Conclusion: The decrease in AUD contacts may be attributed to the improved identification of patients with less severe conditions, as the recording of diagnosis codes has improved. However, notable unmet care needs continue to exist.