Characterizing people with frequent emergency department visits and substance use: a retrospective cohort study of linked administrative data in Ontario, Alberta, and B.C., Canada
Dublin Core
Title
Characterizing people with frequent emergency department visits and substance use: a retrospective cohort study of linked administrative data in Ontario, Alberta, and B.C., Canada
Subject
Emergency medicine, Epidemiology, Health policy, Health services research, Frequent Users, High Service
Users, Substance-Related Disorders
Users, Substance-Related Disorders
Description
Background: Substance use is common among people who visit emergency departments (EDs) frequently. We
aimed to characterize subgroups within this cohort to better understand care needs/gaps, and generalizability of
characteristics in three Canadian provinces.
Methods: This was a retrospective cohort study (April 1st, 2013 to March 31st, 2016) of ED patients in Ontario, Alberta,
and British Columbia (B.C.) We included patients≥18 years with substance use-related healthcare contact during the
study period and frequent ED visits, defned as those in the top 10% of ED utilization when all patients were ordered
by annual ED visit number. We used linked administrative databases including ED visits and hospitalizations (all provinces); mental heath-related hospitalizations (Ontario and Alberta); and prescriptions, physician services, and mortality
(B.C.). We compared to cohorts of people with (1) frequent ED visits and no substance use, and (2) non-frequent ED
visits and substance use.
We employed cluster analysis to identify subgroups with distinct visit patterns and clinical characteristics during index
year, April 1st, 2014 to March 31st, 2015.
Results: In 2014/15, we identifed 19,604, 7,706, and 9,404 people with frequent ED visits and substance use in
Ontario, Alberta, and B.C (median 37–43 years; 60.9–63.0% male), whose ED visits and hospitalizations were higher
than comparison groups.
In all provinces, cluster analyses identifed subgroups with “extreme” and “moderate” frequent visits (median 13–19
versus 4–6 visits/year). “Extreme” versus “moderate” subgroups had more hospitalizations, mental health-related ED
visits, general practitioner visits but less continuity with one provider, more commonly left against medical advice,
and had higher 365-day mortality in B.C. (9.3% versus 6.6%; versus 10.4% among people with frequent ED visits and
aimed to characterize subgroups within this cohort to better understand care needs/gaps, and generalizability of
characteristics in three Canadian provinces.
Methods: This was a retrospective cohort study (April 1st, 2013 to March 31st, 2016) of ED patients in Ontario, Alberta,
and British Columbia (B.C.) We included patients≥18 years with substance use-related healthcare contact during the
study period and frequent ED visits, defned as those in the top 10% of ED utilization when all patients were ordered
by annual ED visit number. We used linked administrative databases including ED visits and hospitalizations (all provinces); mental heath-related hospitalizations (Ontario and Alberta); and prescriptions, physician services, and mortality
(B.C.). We compared to cohorts of people with (1) frequent ED visits and no substance use, and (2) non-frequent ED
visits and substance use.
We employed cluster analysis to identify subgroups with distinct visit patterns and clinical characteristics during index
year, April 1st, 2014 to March 31st, 2015.
Results: In 2014/15, we identifed 19,604, 7,706, and 9,404 people with frequent ED visits and substance use in
Ontario, Alberta, and B.C (median 37–43 years; 60.9–63.0% male), whose ED visits and hospitalizations were higher
than comparison groups.
In all provinces, cluster analyses identifed subgroups with “extreme” and “moderate” frequent visits (median 13–19
versus 4–6 visits/year). “Extreme” versus “moderate” subgroups had more hospitalizations, mental health-related ED
visits, general practitioner visits but less continuity with one provider, more commonly left against medical advice,
and had higher 365-day mortality in B.C. (9.3% versus 6.6%; versus 10.4% among people with frequent ED visits and
Creator
Jessica Moe , Yueqiao Elle Wang, Michael J. Schull, Kathryn Dong, Margaret J. McGregor, Corinne M. Hohl, Brian R. Holroyd and Kimberlyn M. McGrail
Publisher
BMC Emergency Medicine
Date
(2022) 22:127
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Jessica Moe , Yueqiao Elle Wang, Michael J. Schull, Kathryn Dong, Margaret J. McGregor, Corinne M. Hohl, Brian R. Holroyd and Kimberlyn M. McGrail , “Characterizing people with frequent emergency department visits and substance use: a retrospective cohort study of linked administrative data in Ontario, Alberta, and B.C., Canada,” Repository Horizon University Indonesia, accessed January 30, 2025, https://repository.horizon.ac.id/items/show/4128.