title: Emergency department and hospital utilization among alcohol and drug-dependent detoxification patients without primary medical care.
abstract: Utilization of emergency department (ED) services and hospitalization among a cohort of substance abusers are described based on structured research interviews with 470 adults without primary care admitted to an urban residential detoxification program. Cross-sectional analysis of baseline data of subjects found nearly 19% of subjects went to an ED on 2 or more occasions in the 6 months prior to detoxification and 14% were admitted for an overnight hospitalization. Upon further analysis of past 6-month ED utilization, the following factors were independently associated with increased odds of ED use: White race; at least one month homeless in the past 5 years chronic health condition; injury in past 6 months; and subject perception that their substance abuse interfered with seeking care from a regular doctor. Subjects with cocaine as a primary problem had lower odds of ED utilization than a reference group with alcohol as a primary problem.
authors.affiliation: New England Research Institutes, Watertown, Massachusetts 02472, USA. mjlarson@neriscience.com
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Larson
authors.forename: Richard
authors.initials: R
authors.lastname: Saitz
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Horton
authors.forename: Christine
authors.initials: C
authors.lastname: Lloyd-Travaglini
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation*; D002391:Catchment Area, Health; D003430:Cross-Sectional Studies; D003710:Demography; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008658:Inactivation, Metabolic; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation; D011795:Surveys and Questionnaires