Substance Abuse Treatment, Prevention, and Policy | |
Frequencies of emergency department use and hospitalization comparing patients with different types of substance or polysubstance-related disorders | |
Zhirong Cao1  Bahram Armoon1  Guy Grenier1  Marie-Josée Fleury2  Christophe Huỳnh3  | |
[1] Douglas Hospital Research Centre, Douglas Mental Health University Institute, 6875 LaSalle Blvd, H4H 1R3, Montreal, QC, Canada;Douglas Hospital Research Centre, Douglas Mental Health University Institute, 6875 LaSalle Blvd, H4H 1R3, Montreal, QC, Canada;Department of Psychiatry, McGill University, 1033 Pine Avenue West, H3A 1A1, Montreal, QC, Canada;Institut universitaire sur les dépendances du Centre intégré universitaire de santé et des services sociaux du Centre-Sud-de-l’Île-de-Montréal, 950 Louvain Est, H2M 2E8, Montréal, Québec, Canada; | |
关键词: Emergency department use; Hospitalization; Substance-related disorders; Mental disorders; Clinical variables; Sociodemographic variables; Service use variables; | |
DOI : 10.1186/s13011-021-00421-7 | |
来源: Springer | |
【 摘 要 】
BackgroundThis study measured emergency department (ED) use and hospitalization for medical reasons among patients with substance-related disorders (SRD), comparing four subgroups: cannabis-related disorders, drug-related disorders other than cannabis, alcohol-related disorders and polysubstance-related disorders, controlling for various clinical, sociodemographic and service use variables.MethodsClinical administrative data for a cohort of 22,484 patients registered in Quebec (Canada) addiction treatment centers in 2012-13 were extracted for the years 2009-10 to 2015-16. Using negative binomial models, risks of frequent ED use and hospitalization were calculated for a 12-month period (2015-16).ResultsPatients with polysubstance-related disorders used ED more frequently than other groups with SRD. They were hospitalized more frequently than patients with cannabis or other drug-related disorders, but less frequently than those with alcohol-related disorders. Patients with alcohol-related disorders used ED more frequently than those with cannabis-related disorders and underwent more hospitalizations than both patients with cannabis-related and other drug-related disorders. Co-occurring SRD-mental disorders or SRD-chronic physical illnesses, more years with SRD, being women, living in rural territories, more frequent consultations with usual general practitioner or outpatient psychiatrist, and receiving more interventions in community healthcare centers increased frequency of ED use and hospitalization, whereas both adverse outcomes decreased with high continuity of physician care. Behavioral addiction, age less than 45 years, living in more materially deprived areas, and receiving 1-3 interventions in addiction treatment centers increased risk of frequent ED use, whereas living in semi-urban areas decreased ED use. Patients 25-44 years old receiving 4+ interventions in addiction treatment centers experienced less frequent hospitalization.ConclusionFindings showed higher risk of ED use among patients with polysubstance-related disorders, and higher hospitalization risk among patients with alcohol-related disorders, compared with patients affected by cannabis and other drug-related disorders. However, other variables contributed substantially more to the frequency of ED use and hospitalization, particularly clinical variables regarding complexity and severity of health conditions, followed by service use variables. Another important finding was that high continuity of physician care helped decrease the use of acute care services. Strategies like integrated care and outreach interventions may enhance SRD services.
【 授权许可】
CC BY
【 预 览 】
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