Predictors of Frequent Emergency Department Use and Hospitalization among Patients with Substance-Related Disorders Recruited in Addiction Treatment Centers

Abstract

Few studies have assessed the overall impact of outpatient service use on acute care use, comparing patients with different types of substance-related disorders (SRD) and multimorbidity. This study aimed to identify sociodemographic and clinical characteristics and outpatient service use that predicted both frequent ED use (3+ visits/year) and hospitalization among patients with SRD. Data emanated from 14 Quebec (Canada) addiction treatment centers. Quebec administrative health databases were analyzed for a cohort of 17,819 patients over a 7-year period. Multivariable logistic regression models were produced. Patients with polysubstance-related disorders, co-occurring SRD-mental disorders, severe chronic physical illnesses, and suicidal behaviors were at highest risk of both frequent ED use and hospitalization. Having a history of homelessness, residing in rural areas, and using more outpatient services also increased the risk of acute care use, whereas high continuity of physician care protected against acute care use. Serious health problems were the main predictor for increased risk of both frequent ED use and hospitalization among patients with SRD, whereas high continuity of care was a protective factor. Improved quality of care, motivational, outreach and crisis interventions, and more integrated and collaborative care are suggested for reducing acute care use.

Acute care utilization and its associated determinants among patients with substance‐related disorders: A worldwide systematic review and meta‐analysis

“…In line with previous studies, there was an association between alcohol and other drug use disorders and an enhanced risk for ED use and hospitalization among patients with SRDs (Armoon et al, 2021; Fleury et al, 2022). The studies highlighted that the main abused substances among patients with SRDs included alcohol (Wu et al, 2012) and cannabis (Campbell et al, 2017).…”

Modeling the Therapeutic Process of Patients with Cocaine Use Disorders: A Guide for Predicting Readmission

“…Two other variables that have been shown to predict readmission are having a previous history of treatment and being referred to addiction treatment by medical services. Regarding the former variable, our study has shown that this is associated with the time spent in treatment (patients with previous admissions spend less time in treatment), and other studies have shown its relationship with treatment outcomes [57, 58]. Regarding the latter variable, the observation that readmission is less common among those who have been referred by a clinician could reflect the fact that healthcare professionals have greater authority or influence than others in promoting the benefits of starting addiction treatment.…”

Predictors of Physician Follow-Up Care Among Patients Affected by an Incident Mental Disorder Episode in Quebec (Canada): Prédicteurs des soins du suivi médical des patients affectés par un épisode incident de troubles mentaux au Québec (Canada)

“…High ED use referred to a minimum of 3+ ED visits per year. 32,33 Studies report that high ED users are often patients without adequate follow-up care, 34 and that ED care is one of the costliest options. 35…”