药物相关诊断患者的急诊护理利用

Q1 Psychology

Addictive Behaviors Reports Pub Date : 2024-12-01 DOI:10.1016/j.abrep.2024.100573

Wayne Kepner , Natasia S. Courchesne-Krak , Nora Satybaldiyeva , Rekha Narasimhan , Carla B. Marienfeld

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引用次数: 0

摘要

物质使用是急诊就诊的一个重要因素。关于物质相关诊断（SRD）个体的ED使用模式知之甚少。我们使用来自加利福尼亚大型医疗保健系统的电子健康记录（EHR）来检查患有SRDs的个体的ED医疗保健利用和社会人口统计学特征。方法：我们使用2012年4月至2019年9月我国卫生系统中所有成年患者的电子病历数据，进行调整后的logistic回归模型，以确定SRD的社会人口学相关性（例如，使用、滥用、依赖）以及SRD与接受急诊护理之间的关联。结果样本（n = 342,651）中，女性居多（55.08%），非西班牙裔白人居多（58.10%），平均年龄48.26岁（SD = 18.10）， SRD患者18,015例（5.26%）。诊断为酒精相关的患者访问ED的几率最高（aOR = 3.75），其次是阿片类药物（aOR = 3.57）和兴奋剂相关的诊断（aOR = 3.48）。患有SRD的人更有可能认为自己是男性，黑人/非裔美国人，西班牙裔/拉丁裔，没有医疗保险，并且有严重的精神疾病。在调整后的模型中，有SRD的患者比没有SRD的患者更有可能接受过紧急护理（aOR 3.72 [95% CI 3.62-3.84]）。我们的研究发现SRD与利用紧急卫生服务之间存在关联。人口统计学特征表明，在性别、种族/民族、保险状况和心理健康方面存在着性别差异。这些数据有助于筛查和有针对性的应对措施，以预防或提供紧急护理。

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Emergency care utilization in persons with substance related diagnoses

Background

Substance use is a significant contributor to emergency department (ED) visits. Little is known about ED utilization patterns of individuals with substance related diagnosis (SRD). We used electronic health records (EHR) from a large healthcare system in California to examine ED healthcare utilization and socio-demographic characteristics of individuals with SRDs.

Methods

We used EHR data on all adult patients in our health system from April 2012 through September 2019 to conduct adjusted logistic regression models to determine socio-demographic correlates of SRDs (e.g., use, misuse, dependence) and associations between having an SRD and receiving emergency care.

Results

Among the sample (n = 342,651), the majority were female (55.08 %), Non-Hispanic White (58.10 %), with mean age of 48.26 (SD = 18.10), and there were 18,015 (5.26 %) individuals with an SRD. Patients with an alcohol-related diagnosis had the highest odds of visiting the ED (aOR = 3.75), followed by those with opioid (aOR = 3.57) and stimulant-related diagnoses (aOR = 3.48). Individuals with an SRD were more likely to identify as male, Black/African American, Hispanic/Latinx, have no health insurance, and have a serious mental illness. In the adjusted model, those with an SRD were significantly more likely to have ever received emergency care (aOR 3.72 [95 % CI 3.62–3.84]) than those without an SRD.

Discussion

Our study found an association between having an SRD and utilizing emergency health services. Demographic characteristics suggest disparities exist for those with SRDs around gender, race/ethnicity, insurance status, and mental health. These data can help with screening and targeted responses to prevent or provide emergency care.

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来源期刊

Addictive Behaviors Reports Medicine-Psychiatry and Mental Health

CiteScore

6.80

自引率

0.00%

发文量

审稿时长

71 days

期刊介绍： Addictive Behaviors Reports is an open-access and peer reviewed online-only journal offering an interdisciplinary forum for the publication of research in addictive behaviors. The journal accepts submissions that are scientifically sound on all forms of addictive behavior (alcohol, drugs, gambling, Internet, nicotine and technology) with a primary focus on behavioral and psychosocial research. The emphasis of the journal is primarily empirical. That is, sound experimental design combined with valid, reliable assessment and evaluation procedures are a requisite for acceptance. We are particularly interested in ''non-traditional'', innovative and empirically oriented research such as negative/null data papers, replication studies, case reports on novel treatments, and cross-cultural research. Studies that might encourage new lines of inquiry as well as scholarly commentaries on topical issues, systematic reviews, and mini reviews are also very much encouraged. We also welcome multimedia submissions that incorporate video or audio components to better display methodology or findings.