Hospital discharge location and socioeconomic deprivation as risk factors for alcohol dependence relapses: A cohort study

Abstract

BackgroundThere is evidence that social support can improve the ability of an individual with alcohol use disorder to manage relapses. However, the role of families and friends in this context is debated as family history and co-drinking are also risk factors for initiating alcohol drinking or maintaining addictive behaviours. AimTo quantitatively evaluate whether the hospital discharge location (in company or alone) after an alcohol dependence hospitalisation can influence the risk of relapses and whether this impact is modified by socioeconomic deprivation. MethodsA cohort of 1141 patients hospitalised for the first time for alcohol dependence in Scotland between 2010 and 2019 was derived from a routine healthcare database. Relapses were defined as recurrent alcohol-related hospitalisation. Survival analysis was undertaken to compare the risk of relapse for different discharge locations and socioeconomic deprivation groups. ResultsOn average, living in company of others was associated with a significant lower risk of relapses compared to living alone (HR: 0.84 95%CI: 0.71–0.99). This association differed across socioeconomic groups, being greater for those living in areas with the highest level of socioeconomic deprivation (HR: 0.76 95%CI: 0.57–1.01) and lower elsewhere. While this effect was not statistically significant (p = 0.056), its extent varied based on how we defined our cohort: it was not detectable when we expanded the cohort to all individuals with alcohol use disorders. ConclusionHome settings and the environment where individuals reside should be considered as significant psychosocial factors when clinicians design therapies and hospital discharge planning for patients with alcohol dependence.