Health Care Utilization of Chronic Inebriates

Thornquist, Lisa; Biros, Michelle H.; Olander, Robert; Sterner, Steven

doi:10.1111/j.1553-2712.2002.tb01323.x

Cited by 30 publications

(23 citation statements)

References 11 publications

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“…2 Interventions that have addressed homelessness have had success in decreasing ED visits, 28,29 decreasing problem drug use, 29 and decreasing the costs of associated services such as detoxification centres. 30 …”

Section: Discussionmentioning

confidence: 99%

Frequent users of an inner-city emergency department

Geurts

Palatnick²,

Strome³

et al. 2012

CJEM

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Background: Within the emergency department (ED) patient population there is a subset of patients who make frequent visits. This chart review sought to characterize this population and identify strategies to reduce frequent ED visits. Methods: Frequent use at an urban tertiary care centre was defined as 15 or more visits over 1 year. The details of each visit-demographics, entrance complaint, discharge diagnosis, arrival method, Canadian Triage and Acuity Scale (CTAS) score, and length of stay-were analyzed and compared to data from the entire ED population for the same period. Results: Ninety-two patients generated 2,390 ED visits (of 25,523 patients and 44,204 visits). This population was predominantly male (66%) and middle-aged (median 42 years), with no fixed address (27.2%). Patients arrived by ambulance in 59.3% of visits with less acute CTAS scores than the general population. Substance use accounted for 26.9% of entrance complaints. Increased lengths of stay were associated with female gender and abnormal vital signs, whereas shorter stays were associated with no fixed address and substance use (p , 0.05). Admissions were lower than the general population, and women were twice as likely as men to be admitted (p , 0.05). Patients left without being seen in 15.8% of visits. Conclusions: High-frequency ED users are more likely to be male, younger, and marginally housed and to present secondary to substance use. Although admissions among this population are low, the costs associated with these presentations are high. Interventions designed to decrease visits and improve the health of this population appear warranted.

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Section: Discussionmentioning

confidence: 99%

Frequent users of an inner-city emergency department

Geurts

Palatnick²,

Strome³

et al. 2012

CJEM

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“…This overestimation may be caused by the fact that these clients accounted for almost one third of all treatment requests during this registration period and, therefore, put a heavy burden on treatment services. In addition, these caregivers experienced the treatment of these clients as frustrating and challenging, since standard treatment usually fails with this population [35] .…”

Section: Nature and Extent Of The Problemmentioning

confidence: 99%

“…Moreover, as traditional treatment agencies have proven to be relatively ineffective for this population [16,18,19,35,36] , alternative approaches to dealing with this problem are needed.…”

Section: Aims Of the Studymentioning

confidence: 99%

“…Intensive case management is characterized by a comprehensive, individualized, and continuous approach, assertive outreach, and the provision of direct services by one single case manager. This intervention is specifically targeted at the so-called revolving door clients, since some evidence is available that it is effective for reducing the use of expensive inpatient services, enhancing participation in community-based services, and stabilizing and improving clients' situations [17,35,36,51] .…”

Section: Characteristics Of Multiple Agency Attendeesmentioning

confidence: 99%

“…Moreover, we wanted to explore factors that could differentiate between clients who asked for treatment in various substance abuse agencies within a relatively short period of time and those who did so in one single service. Ultimately, these empirical data should contribute to a better coordination of service provision and to more quality of care for substance abusers [22,35,37] .…”

Section: Aims Of the Studymentioning

confidence: 99%

See 2 more Smart Citations

Comparison of Single and Multiple Agency Clients in Substance Abuse Treatment Services

Colpaert¹,

Vanderplasschen²,

Broekaert³

2007

Eur Addict Res

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Background: Frequent and multiple service utilization among substance abusers is a well-known problem. However, little statistical evidence exists about overlapping agency populations. Methods: This phenomenon was studied in a clear-cut region in Belgium, based on intake information concerning all clients who addressed a drug treatment center within a 6-month period (n=1,139). Results: Multiple service utilization was rather common but not omnipresent during this particular registration period. Almost 15% of the clients were registered in more than one substance abuse treatment agency. Compared to single agency attendees, multiple agency clients appeared to be more often poly-substance abusers with a longer previous treatment history and greater problem severity. Conclusion: A continuous care perspective, interagency collaboration and a common tracking and documentation system are recommended to better address the needs of this specific subgroup of substance abusers. More research is needed to clarify whether these multiple service utilization patterns are caused by client-related, agency-related or other factors.

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Alcohol diagnoses among older Tennessee Medicare beneficiaries: race and gender differences

Kilbourne

Cummings

Levine

2011

Int J Geriat Psychiatry

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Many encounters with the medical system result in missed opportunities to identify and treat alcohol disorders, a significant risk factor among older adults. Alcoholism both triggers and exacerbates many chronic conditions among older adults. The earlier in the disease trajectory the more of these conditions could be prevented or more efficiently managed, resulting in substantial savings in health care costs.

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Health Care Utilization of Chronic Inebriates

Abstract: These programs reduced health care use for most patients. However, serious medical illness or injury in a small number of patients contributed heavily to resource utilization.

Cited by 30 publications

References 11 publications

Frequent users of an inner-city emergency department

Frequent users of an inner-city emergency department

Comparison of Single and Multiple Agency Clients in Substance Abuse Treatment Services

Alcohol diagnoses among older Tennessee Medicare beneficiaries: race and gender differences

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