Predictors of hospitalization for injection drug users seeking care for soft tissue infections.
BACKGROUND
Soft tissue infections (STIs) from injection drug use are a common cause of Emergency Department visits, hospitalizations, and operating room procedures, yet little is known about factors that may predict the need for these costly medical services.


OBJECTIVE
To describe a cohort of injection drug users seeking Emergency Department care for STIs and to identify risk factors associated with hospitalization. We hypothesized that participants who delayed seeking care would be hospitalized more often than those who did not.


METHODS
Cohort study using in-person structured interviews and medical record review. Logistic regression assessed the association between hospital admission and delay in seeking care as well as other demographic, clinical, and psychosocial factors.


METHODS
Injection drug users who sought Emergency Department care for STIs from May 2001 to March 2002.


RESULTS
Of the 136 participants, 55 (40%) were admitted to the hospital. Delay in seeking care was not associated with hospital admission. Participants admitted for their infection were significantly more likely to be living in a shelter (P = .01) and to report being hospitalized 2 or more times in the past year (P < .01).


CONCLUSIONS
We identified a subpopulation of injection drug users, mostly living in shelters, who were hospitalized frequently in the past year and who were more likely to be hospitalized for their current infections compared to others. As members of this subpopulation can be easily identified and located, they may benefit from interventions to reduce the health care utilization resulting from these infections.
Takahashi
Traci A
TA
VA Puget Sound Health Care System, Seattle, WA 98108, USA. traci@u.washington.edu
Baernstein
Amy
A
Binswanger
Ingrid
I
Bradley
Katharine
K
Merrill
Joseph O
JO
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006301:Health Services Needs and Demand; D006760:Hospitalization; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011237:Predictive Value of Tests; D018461:Soft Tissue Infections / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000628:therapy