Predictors of Repeated Emergency Department Visits among Persons Treated for Addiction

Abstract

Background/Aims: To determine whether frequent emergency department (ED) users who enter specialized treatment programs for alcohol and/or drug problems have any characteristics that predict their future ED use. Methods: Adult patients (783 alcohol users, 405 illicit drug users) were interviewed. Data from the medical database on utilization of ED and the emergency departments’ specific units for addictive diseases (EDAD) 12 months before and 12 months after the interview were linked with patient characteristics in logistic regression models. Results: Among alcohol users, prior ED/EDAD visits predicted repeat future visits to these sites (OR 11.6; 95% CI 6.5–20.5). Prior inpatient hospital care with addiction diagnosis was a predictor of future multiple visits to the EDAD only (OR 3.1; 95% CI 1.5–6.5). Among drug users, predictors of future ED/EDAD visits were use of heroin (OR 2.7; 95% CI 1.4–5.4) and prior ED/EDAD visits (OR 27.3; 95% CI 12.7–58.4). Drug users’ EDAD utilization was also predicted by inpatient hospital care with addiction diagnosis. Conclusion: The strongest predictive factors of visiting ED repeatedly were previous repeat emergency care use and hospitalization with addiction diagnosis. Entering regular addiction treatment does not appear to alter the pattern of ED utilization.

Key challenges in providing services to people who use drugs: The perspectives of people working in emergency departments and shelters in Atlantic Canada

“…Studies, including Canadian studies, have found, for example, that PWUD seeking health care are more likely to do so via emergency departments (EDs) rather than primary care services (Hansagi, Engdahl, & Romelsjö, 2012; Kerr et al., 2005; Palepu et al., 2001), with the unstably housed making relatively frequent visits to EDs (Fairbairn et al., 2011; Haber, Demirkol, Lange, & Murnion, 2009; Palepu et al., 1999, 2001). These findings have been interpreted to mean that the most socially marginalized PWUD, such as those who are homeless, are not only more likely to suffer poorer health, but that they are also less able to establish on-going relationships with health care providers and/or address health concerns before they become acute (Palepu et al., 1999).…”

Mental and behavioral disorders in the population of homeless patients admitted to hospital emergency departments

“…There are no papers in the Polish literature describing mental and behavioral disorders in the population of homeless patients admitted to hospital emergency departments. Although care for homeless people has become an everyday routine in hospital emergency departments [33][34][35][36], while mental and behavioral disorders are relatively frequent among the homeless population, literature on this subject is very limited, especially in Europe. The study results present diverse data, and their analysis shows the complex nature of the problem.…”

“…W piśmiennictwie polskim nie ma prac, które opisywałyby zaburzenia psychiczne i zaburzania zachowania w populacji bezdomnych pacjentów przyjmowanych w szpitalnych oddziałach ratunkowych. Mimo że opieka nad bezdomnymi osobami stała się codziennością w szpitalnych oddziałach ratunkowych [33][34][35][36], a zaburzenia psychiczne i zaburzania zachowania są diagnozowane w populacji bezdomnych osób stosunkowo często, literatura na ten temat jest uboga, zwłaszcza w Europie. Wyniki badań przedstawiają zróżnicowane dane, a ich analiza pokazuje złożoność problemu.…”

Voices of Homeless Alcoholics Who Frequent Bellevue Hospital: A Qualitative Study

“…1,2 Chronically alcohol-dependent, homeless individuals are fixtures in many emergency departments (EDs) and disproportionately affect health care infrastructure and the increasing costs of public health. [3][4][5][6][7][8][9][10][11][12] Despite their repeated ED and detoxification unit admissions, this group experiences poor health and appears incapable of escaping social circumstances that perpetuate and exacerbate their problems.…”