title: Methamphetamine-related emergency department utilization and cost.
abstract: OBJECTIVE
  To quantify the frequency, cost, and characteristics associated with emergency department (ED) visits that are related to methamphetamine use.
  
  
  METHODS
  This was a prospective observational study. The authors performed a training program for ED clinicians on the acute and chronic effects of methamphetamine and the signs of methamphetamine abuse. A standardized two question survey was administered to clinicians concerning the relationship between the ED visit and the patient's methamphetamine use. The survey was embedded in the patient tracking system and was required for all ED patients before disposition. Survey results were merged with administrative data on demographics, diagnosis, disposition, and charges. Univariate analyses were used to determine patient characteristics associated with methamphetamine-related ED visits.
  
  
  RESULTS
  The authors examined 15,038 ED visits over a 20-week period from February 2006 to June 2006. There were a total of 353 methamphetamine-related visits, for an average of 17.65 visits per week (2.4% of all visits). Hospital charges for methamphetamine-related ED visits averaged $133,181 per week, for an estimated total of $6.9 M in annual charges. Methamphetamine-related ED patients were more likely to be male (odds ratio [OR] 1.6, 95% confidence interval [CI] = 1.30 to 2.01), white (OR 1.8, 95% CI = 1.38 to 2.29), and uninsured (OR 3.2, 95% CI = 2.21 to 4.69). The top four medical conditions associated with methamphetamine-related visits were mental health (18.7%), trauma (18.4%), skin infections (11.1%), and dental diagnoses (9.6%).
  
  
  CONCLUSIONS
  Methamphetamine abuse accounts for a modest but substantial proportion of ED utilization and hospital cost. Methamphetamine-related ED visits are most commonly related to mental illness, trauma, skin, and dental-related problems.
authors.affiliation: Department of Emergency Medicine, Center for Policy Research in Emergency Medicine, Oregon Health and Science University, Portland, OR, USA. hendriro@ohsu.edu
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hendrickson
authors.forename: Robert
authors.initials: R
authors.lastname: Cloutier
authors.forename: K John
authors.initials: KJ
authors.lastname: McConnell
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000191:economics* / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000191:economics* / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008694:Methamphetamine; D009922:Oregon / Q000453:epidemiology; D011446:Prospective Studies; D017678:Sex Distribution; D014600:Utilization Review
chemical_list: D008694:Methamphetamine