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Background: We examined the probabilities of longitudinal care outcomes of working-aged patients with alcohol-use disorder (AUD) and their alcohol-related treatment utilisation patterns across the healthcare services, by using linked electronic health records. Methods: A random sample (n = 396) of patients with alcohol-related visits to healthcare services in 2011–2012 was collected retrospectively from the electronic health record data in the North Karelia region of Finland and followed prospectively in time until the end of 2016. Data on care outcomes and alcohol-related healthcare use were gathered from the electronic health records. Three outcome groups were identified: (1) dead, (2) present AUD, and (3) remission. Group differences in alcohol-related health service use were compared. Results: At the end of the follow-up period, an increased mortality rate of 22.9% was observed, and 18.4% had achieved stable remission, while for the majority (56%), the AUD remained. Most of those in remission had contact with either specialised AUD services or mental health services. Conversely, the majority of those who had died had no contact with specialised AUD services during the follow-up period. Conclusions: The electronic-health-record-based register analysis captured mainly individuals with advanced forms of AUD. An excess mortality rate and other negative health consequences were observed. Training providers to identify and treat earlier the less severe forms of AUD could have major benefit to patients and also reduce health system costs.

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