Setting of Alcohol Use Disorder Diagnosis Among Women Enrolled in Medicare

Objective The authors assessed the setting of an initial diagnosis of alcohol use disorder among Medicare-enrolled women.Methods Using 2016-2022 Medicare fee-for-service claims, the authors identified the first alcohol use disorder diagnosis for women ages 18-64 years (N=116,226) and ≥65 years (N=264,857) and examined the diagnosis setting. For diagnoses during a hospitalization, the authors determined how often alcohol use disorder was the principal diagnosis.Results About two-thirds of women ages 18-64 and ≥65 years received an initial diagnosis in a hospital or emergency department. Only 9%-14% of diagnoses were by primary care physicians and 2%-5% by behavioral health specialists in community-based practices. Alcohol use disorder was the principal diagnosis for ≤10% of hospitalizations in which a patient's condition was initially diagnosed, suggesting that it was often identified during acute treatment for other conditions.Conclusions These results suggest the need for enhanced efforts to encourage early identification and management of alcohol use disorder outside acute care settings.