This research examines whether (1) hospital emergency department patients needing alcohol and/or other psychoactive drug (AOD) treatment utilize more healthcare services than those not needing treatment, and whether (2) any such differential emerges among patients on TennCare. Using two-stage probability sampling, adult patients (n=1,502) were drawn from seven representative Tennessee civilian, non-psychiatric, non-rehabilitation hospitals with an emergency department (ED). Data were obtained from ED logs, personal interviews, medical records, and toxicological screens. AOD presence was tested using rapid assay saliva and urine tests. Chi-square tests and multiple logistic regression procedures were implemented with SUDAAN software, which accommodated the complex unequal probability sampling design. Patients (22% of cases) were assessed as needing treatment if they met any of 12 criteria incorporating AOD use, dependence and treatment histories, positive toxicological test results, and test refusals. The four outcome measures were self-reported number of physician visits, ED/clinic visits and hospitalizations in the past 12 months, and hospital ED case disposition (admitted or discharged). Patients needing treatment show a 45% excess likelihood of one or more ED/clinic visits and a 66% excess likelihood of at least one hospital admission in the past 12 months. They also exhibit a 61% excess likelihood of being admitted. No healthcare utilization differentials are manifested among TennCare patients by AOD treatment need status. (But they show a 47% excess likelihood of treatment need compared to privately insured patients). EDs represent a largely untapped frontline in the identification and treatment of AOD dependent persons.
Learning Objectives: (1) to understand the relationship between alcohol and other drug(AOD) treatment need and utilization of healthcare services. (2) to identify predictors of utilization of healthcare services. (3) to assess the importance of hospital emergency departments in identification and treatment of AOD dependent persons
Keywords: Drug Abuse Treatment, Emergency Department/Room
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.