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Resource consumption of multi-substance users in the emergency room: A neglected patient group

BACKGROUND: Multi-substance use is accompanied by increased morbidity and mortality and responsible for a large number of emergency department (ED) consultations. To improve the treatment for this vulnerable group of patients, it is important to quantify and break down in detail the ED resources use...

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Autores principales: Klenk, Laurence, von Rütte, Christina, Henssler, Jonathan F., Sauter, Thomas C., Hautz, Wolf E., Exadaktylos, Aristomenis K., Müller, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6763017/
https://www.ncbi.nlm.nih.gov/pubmed/31557239
http://dx.doi.org/10.1371/journal.pone.0223118
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author Klenk, Laurence
von Rütte, Christina
Henssler, Jonathan F.
Sauter, Thomas C.
Hautz, Wolf E.
Exadaktylos, Aristomenis K.
Müller, Martin
author_facet Klenk, Laurence
von Rütte, Christina
Henssler, Jonathan F.
Sauter, Thomas C.
Hautz, Wolf E.
Exadaktylos, Aristomenis K.
Müller, Martin
author_sort Klenk, Laurence
collection PubMed
description BACKGROUND: Multi-substance use is accompanied by increased morbidity and mortality and responsible for a large number of emergency department (ED) consultations. To improve the treatment for this vulnerable group of patients, it is important to quantify and break down in detail the ED resources used during the ED treatment of multi-substance users. METHODS: This retrospective single centre case-control study included all ED consultations of multi-substance users over a three-year study period at a university hospital in Switzerland. Resource consumption of these patients was compared to an age-matched control group of non-multi-substance users. RESULTS: The analysis includes 867 ED consultations of multi-substance users compared to 4,335 age-matched controls (5:1). Multi-substance users needed more total resources (median tax points [medical currency] (IQR): 762 (459–1226) vs. 462 (196–833), p<0.001), especially physician, radiology, and laboratory resources. This difference persisted in multivariable analysis (geometric mean ratio (GMR) 1.2, 95% CI: 1.1–1.3, p = 0.001) adjusted for sociodemographic parameters, consultation characteristics, and patient comorbidity; the GMR was highest in ED laboratory and radiology resource consumption. Among multi-substance user, indirect and non-drug-related consultations had higher ED resource consumption compared to drug-related consultations. Furthermore, leading discipline as well as urgency were predictors of ED resource consumption. Moreover, multi-substance users had more revisits (55.2% vs. 24.9%, p<0.001) as well as longer ED and in-hospital stays (both: GMR 1.2, 95% CI: 1.1–1.3, p<0.001). CONCLUSION: ED consultations of multi-substance users are expensive and resource intensive. Multi-substance users visited the ED more often and stayed longer at the ED and in-hospital. The findings of our study underline the importance of this patient group. Additional efforts should be made to improve their ED care. Special interventions should target this patient group in order to decrease the high frequency and costs of emergency consultations caused by multi-substance users.
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spelling pubmed-67630172019-10-12 Resource consumption of multi-substance users in the emergency room: A neglected patient group Klenk, Laurence von Rütte, Christina Henssler, Jonathan F. Sauter, Thomas C. Hautz, Wolf E. Exadaktylos, Aristomenis K. Müller, Martin PLoS One Research Article BACKGROUND: Multi-substance use is accompanied by increased morbidity and mortality and responsible for a large number of emergency department (ED) consultations. To improve the treatment for this vulnerable group of patients, it is important to quantify and break down in detail the ED resources used during the ED treatment of multi-substance users. METHODS: This retrospective single centre case-control study included all ED consultations of multi-substance users over a three-year study period at a university hospital in Switzerland. Resource consumption of these patients was compared to an age-matched control group of non-multi-substance users. RESULTS: The analysis includes 867 ED consultations of multi-substance users compared to 4,335 age-matched controls (5:1). Multi-substance users needed more total resources (median tax points [medical currency] (IQR): 762 (459–1226) vs. 462 (196–833), p<0.001), especially physician, radiology, and laboratory resources. This difference persisted in multivariable analysis (geometric mean ratio (GMR) 1.2, 95% CI: 1.1–1.3, p = 0.001) adjusted for sociodemographic parameters, consultation characteristics, and patient comorbidity; the GMR was highest in ED laboratory and radiology resource consumption. Among multi-substance user, indirect and non-drug-related consultations had higher ED resource consumption compared to drug-related consultations. Furthermore, leading discipline as well as urgency were predictors of ED resource consumption. Moreover, multi-substance users had more revisits (55.2% vs. 24.9%, p<0.001) as well as longer ED and in-hospital stays (both: GMR 1.2, 95% CI: 1.1–1.3, p<0.001). CONCLUSION: ED consultations of multi-substance users are expensive and resource intensive. Multi-substance users visited the ED more often and stayed longer at the ED and in-hospital. The findings of our study underline the importance of this patient group. Additional efforts should be made to improve their ED care. Special interventions should target this patient group in order to decrease the high frequency and costs of emergency consultations caused by multi-substance users. Public Library of Science 2019-09-26 /pmc/articles/PMC6763017/ /pubmed/31557239 http://dx.doi.org/10.1371/journal.pone.0223118 Text en © 2019 Klenk et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Klenk, Laurence
von Rütte, Christina
Henssler, Jonathan F.
Sauter, Thomas C.
Hautz, Wolf E.
Exadaktylos, Aristomenis K.
Müller, Martin
Resource consumption of multi-substance users in the emergency room: A neglected patient group
title Resource consumption of multi-substance users in the emergency room: A neglected patient group
title_full Resource consumption of multi-substance users in the emergency room: A neglected patient group
title_fullStr Resource consumption of multi-substance users in the emergency room: A neglected patient group
title_full_unstemmed Resource consumption of multi-substance users in the emergency room: A neglected patient group
title_short Resource consumption of multi-substance users in the emergency room: A neglected patient group
title_sort resource consumption of multi-substance users in the emergency room: a neglected patient group
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6763017/
https://www.ncbi.nlm.nih.gov/pubmed/31557239
http://dx.doi.org/10.1371/journal.pone.0223118
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