Utilization of the emergency department after self-inflicted injury.
OBJECTIVE
To compare emergency department (ED) utilization by individuals who present with self-inflicted injuries with utilization by control populations. Individuals with self-inflicted injuries commonly present to the ED, yet little research has been conducted on this population in this setting.


METHODS
Individuals who had an ED presentation in 1995-1996 for a self-inflicted injury were tracked prospectively for three to four years of follow-up. This group was matched by age and gender to two groups: individuals who presented with asthma and individuals who presented with other complaints. Data on return visits to the ED were collected from an administrative database. Groups were compared on rates of return visits.


RESULTS
There were 478 individuals randomly selected for each group. Individuals in the self-inflicted injury group had higher rates of return visits to the ED over the follow-up period: 232.7 visits per 100 person-years for the self-inflicted injury group, compared with 117.6 for the asthma group, and 83.0 for the "other" group (p < 0.001). The self-inflicted injury group had higher rates for many types of diagnoses: self-inflicted injuries, mental disorders, substance abuse, unintentional injuries, assault, headache pain, and other complaints (all p < 0.001). Patients with more than three repeat visits per year were more common in the self-inflicted injury group (20.1%) than the asthma or "other" groups (9.2% and 5.6%, respectively).


CONCLUSIONS
Individuals who harm themselves are chronic users of the ED. The ED represents an opportune setting from which individuals can be directed to appropriate treatment programs.
Colman
Ian
I
Division of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada.
Dryden
Donna M
DM
Thompson
Angus H
AH
Chahal
Anthony M
AM
Borden
Kim
K
Rowe
Brian H
BH
Voaklander
Donald C
DC
D000328:Adult; D000416:Alberta / Q000453:epidemiology; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy; D011446:Prospective Studies; D012016:Reference Values; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000628:therapy; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000628:therapy*