Resource consumption of multi-substance users in the emergency room: A neglected patient group

Klenk, Laurence; von Rütte, Christina; Henssler, Jonathan F.; Sauter, Thomas C.; Hautz, Wolf E.; Exadaktylos, Aristomenis; Müller, Martin (2019). Resource consumption of multi-substance users in the emergency room: A neglected patient group. PLoS ONE, 14(9), e0223118. Public Library of Science 10.1371/journal.pone.0223118

[img]
Preview
Text
journal.pone.0223118.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (705kB) | Preview

BACKGROUND: Multi-substance use is accompanied by increased morbidity and mortality and responsible for a large number of emergency department (ED) consultations. To improve the treatment for this vulnerable group of patients, it is important to quantify and break down in detail the ED resources used during the ED treatment of multi-substance users. METHODS: This retrospective single centre case-control study included all ED consultations of multi-substance users over a three-year study period at a university hospital in Switzerland. Resource consumption of these patients was compared to an age-matched control group of non-multi-substance users. RESULTS: The analysis includes 867 ED consultations of multi-substance users compared to 4,335 age-matched controls (5:1). Multi-substance users needed more total resources (median tax points [medical currency] (IQR): 762 (459-1226) vs. 462 (196-833), p<0.001), especially physician, radiology, and laboratory resources. This difference persisted in multivariable analysis (geometric mean ratio (GMR) 1.2, 95% CI: 1.1-1.3, p = 0.001) adjusted for sociodemographic parameters, consultation characteristics, and patient comorbidity; the GMR was highest in ED laboratory and radiology resource consumption. Among multi-substance user, indirect and non-drug-related consultations had higher ED resource consumption compared to drug-related consultations. Furthermore, leading discipline as well as urgency were predictors of ED resource consumption. Moreover, multi-substance users had more revisits (55.2% vs. 24.9%, p<0.001) as well as longer ED and in-hospital stays (both: GMR 1.2, 95% CI: 1.1-1.3, p<0.001). CONCLUSION: ED consultations of multi-substance users are expensive and resource intensive. Multi-substance users visited the ED more often and stayed longer at the ED and in-hospital. The findings of our study underline the importance of this patient group. Additional efforts should be made to improve their ED care. Special interventions should target this patient group in order to decrease the high frequency and costs of emergency consultations caused by multi-substance users.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center

UniBE Contributor:

Klenk, Laurence; Sauter, Thomas; Hautz, Wolf; Exadaktylos, Aristomenis and Müller, Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1932-6203

Publisher:

Public Library of Science

Language:

English

Submitter:

Romana Saredi

Date Deposited:

12 Dec 2019 14:14

Last Modified:

15 Dec 2019 07:09

Publisher DOI:

10.1371/journal.pone.0223118

PubMed ID:

31557239

BORIS DOI:

10.7892/boris.136481

URI:

https://boris.unibe.ch/id/eprint/136481

Actions (login required)

Edit item Edit item
Provide Feedback