A 5 year retrospective study of emergency department use in Northwest Ontario: a measure of mental health and addictions needs.
OBJECTIVE
The main objective of this study was to understand the five-year trend in total emergency department (ED) visits, frequency of use, and diagnoses and disposition of patients. Since the region has experienced a profound increase in opioid use disorder since 2009, we were particularly interested in changes in the volume of mental health and addiction (MHA) ED presentations.


METHODS
Retrospective aggregate data analysis of ED visits to the Sioux Lookout Meno Ya Win Health Centre 2010-2014.


RESULTS
ED visit volume increased 29% over the five-year study period, while MHA ED visits increased 73%. The admission rate remained stable at 6.9% of ED visits. Five-year trends in clinically grouped diagnostic categories identified respiratory, MHA, and abdominal/pelvic complaints as the three most common ED presentations. In 2014, MHA presentations accounted for 10.3% of ED visits, 8.7% of admissions, and 20.0% of inter-hospital transfers.


CONCLUSIONS
The dramatic increase in MHA ED visits mirrors the opioid epidemic the region is experiencing. MHA may soon become the commonest ED presentation. If reasons for ED visits serve as a proxy for unmet outpatient needs, increased efforts at developing community MHA services and addressing the related social determinants of health are required.
*Sioux Lookout First Nations Health Authority,Sioux Lookout,ON.
Cai-Lei
CL
Matsumoto
*Sioux Lookout First Nations Health Authority,Sioux Lookout,ON.
Terry
T
O'Driscoll
‡Sioux Lookout Meno Ya Win Health Centre,Sioux Lookout,ON.
Jennifer
J
Lawrance
§Emergency Department,Division of Clinical Sciences,Northern Ontario School of Medicine,Sudbury,ON.
Andre
A
Jakubow
†Division of Clinical Sciences,Northern Ontario School of Medicine,Sudbury,ON.
Sharen
S
Madden
‡Sioux Lookout Meno Ya Win Health Centre,Sioux Lookout,ON.
Len
L
Kelly
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D008603:Mental Health; D009864:Ontario; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000628:therapy; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000628:therapy; D013997:Time Factors; D055815:Young Adult
 addiction; emergency; mental health; utilization