Source:http://linkedlifedata.com/resource/pubmed/id/17588489
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
1
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| pubmed:dateCreated |
2007-6-25
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| pubmed:abstractText |
Understanding why substance-using patients seek care at emergency departments (EDs) and who utilizes such service at high rates is important in tailoring and targeting interventions. We conducted a retrospective/prospective cohort study of 326 medically ill substance-using adults to identify factors associated with 12-month high-frequency utilization of ambulatory care, ED, and inpatient medical care. The majority were actively using heroin (74.6%), cocaine (62.4%), and alcohol (54.4%); 94.8% had a chronic medical condition; and 53.8% reported a chronic mental health condition. High-frequency use of ED (> or = 3 visits) was independently associated with being female (adjusted odds ratio [AOR] = 1.88; 95% confidence interval [95% CI] = 1.12, 3.17), being African American (AOR = 2.36; 95% CI = 1.30, 4.29), being homeless (AOR = 2.07; 95% CI = 1.08, 3.96), a history of > 1 substance abuse treatment episode (AOR = 4.10; 95% CI = 3.28, 10.87), and > or = 1 ambulatory care visit (AOR = 8.94; 95% CI = 3.28, 24.41). However, the combination of having certain chronic conditions (seizure disorder, hepatitis B, and hepatitis C) and accessing ambulatory care was protective against high-frequency use of ED. In contrast, high-frequency use of ambulatory care (> or = 3 visits) was independently associated with having insurance (Medicare/Medicaid: AOR = 2.39; 95% CI = 1.31, 4.69), having HIV/AIDS (AOR = 3.15; 95% CI = 1.70, 5.85), and receiving substance abuse treatment during the study period (AOR = 3.58; 95% CI = 1.61, 7.98) Efforts to redirect medical care to more subacute settings will likely require both capacity building and addressing a client's underlying needs, including homelessness, access to substance abuse treatment, and chronic disease management.
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| pubmed:grant | |
| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:status |
MEDLINE
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| pubmed:month |
Jul
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| pubmed:issn |
0740-5472
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| pubmed:author | |
| pubmed:issnType |
Print
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| pubmed:volume |
33
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
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| pubmed:pagination |
51-9
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| pubmed:dateRevised |
2007-12-3
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| pubmed:meshHeading |
pubmed-meshheading:17588489-Adult,
pubmed-meshheading:17588489-Ambulatory Care,
pubmed-meshheading:17588489-Baltimore,
pubmed-meshheading:17588489-Cohort Studies,
pubmed-meshheading:17588489-Comorbidity,
pubmed-meshheading:17588489-Delivery of Health Care, Integrated,
pubmed-meshheading:17588489-Diagnosis, Dual (Psychiatry),
pubmed-meshheading:17588489-Emergency Medical Services,
pubmed-meshheading:17588489-Female,
pubmed-meshheading:17588489-Hospitals, University,
pubmed-meshheading:17588489-Humans,
pubmed-meshheading:17588489-Male,
pubmed-meshheading:17588489-Mental Disorders,
pubmed-meshheading:17588489-Middle Aged,
pubmed-meshheading:17588489-Patient Admission,
pubmed-meshheading:17588489-Prospective Studies,
pubmed-meshheading:17588489-Referral and Consultation,
pubmed-meshheading:17588489-Retrospective Studies,
pubmed-meshheading:17588489-Risk Factors,
pubmed-meshheading:17588489-Substance-Related Disorders,
pubmed-meshheading:17588489-Utilization Review
|
| pubmed:year |
2007
|
| pubmed:articleTitle |
Factors identifying high-frequency and low-frequency health service utilization among substance-using adults.
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| pubmed:affiliation |
Johns Hopkins University School of Medicine, Baltimore, MD, USA. thomas.o'toole@va.gov
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| pubmed:publicationType |
Journal Article,
Research Support, N.I.H., Extramural
|