Table 4.

Potential Quality Improvement and Outcome Metrics for Integrated ALD care.^14,22

Psychiatric	Psychometric score improvement (QofL, anxiety, depression, sleep, et cetera)
	Negative toxicology (alcohol, other drugs, nicotine) and rates of discordance with patient reports
	Reduced alcohol consumption per subjective report and quantitative biomarkers (i.e. PEth)
	Rates of alcohol treatment engagement, retention, and completion (residential rehabilitation, intensive outpatient, group and/or individual psychotherapy, mutual support group milestones [i.e. AA sobriety coins])
	Reduced alcohol cravings (subjective report or validated questionnaire)
	Rates of regained sobriety and alcohol treatment reengagement after relapse
Medical	Improved LFTs (AST, ALT, Tbili, albumin) and MELD scores
	Reduced healthcare utilization (hospital admissions, ER visits)
	Rates of improved symptoms of decompensated cirrhosis and averted LT evaluations
	Reduced mortality
	Expedited LT timetables (i.e. accelerated time-to-listing)
	Improved LT outcomes (lower rates of de-listing, rates of pre- and post-transplant relapse, graft failure, hospital readmission, post-transplant return-to-function)
Other	Patient and family satisfaction scores and feedback for in-person and/or virtual visits
	Clinical and administrative personnel satisfaction scores and feedback regarding teamwork quality and clinical operations
	Satisfaction scores and feedback from intra- and extramural referring clinicians
	Cost savings generated from reduced healthcare utilization rates (hospital admissions, ER visits)
	Patient access and utilization rates (no-shows, cancellations, intra- and extramural referrals, et cetera)
	Reimbursement and revenue generation

AA, alcoholics anonymous; ALT, alanine aminotransferase; AST, aspartate aminotransferase; ER, emergency room; LFT, liver function tests; LT, liver transplant; MELD, model for end-stage liver disease; PEth, phosphatidylethanol; QofL, quality of life; Tbili, total bilirubin.