Hendrickson Robert G, Cloutier Robert, McConnell K John
Department of Emergency Medicine, Center for Policy Research in Emergency Medicine, Oregon Health and Science University, Portland, OR, USA.
Acad Emerg Med. 2008 Jan;15(1):23-31. doi: 10.1111/j.1553-2712.2007.00006.x.
To quantify the frequency, cost, and characteristics associated with emergency department (ED) visits that are related to methamphetamine use.
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.
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%).
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.
量化与甲基苯丙胺使用相关的急诊科（ED）就诊的频率、费用及特征。
这是一项前瞻性观察性研究。作者为急诊科临床医生开展了关于甲基苯丙胺的急性和慢性影响以及甲基苯丙胺滥用迹象的培训项目。针对临床医生进行了一项包含两个问题的标准化调查，内容涉及急诊就诊与患者甲基苯丙胺使用之间的关系。该调查嵌入患者追踪系统，所有急诊患者在出院前均需完成。调查结果与关于人口统计学、诊断、出院情况及费用的管理数据合并。采用单因素分析来确定与甲基苯丙胺相关的急诊就诊患者的特征。
作者在2006年2月至2006年6月的20周期间检查了15,038例急诊就诊病例。共有353例与甲基苯丙胺相关的就诊病例，平均每周17.65例（占所有就诊病例的2.4%）。与甲基苯丙胺相关的急诊就诊的医院费用平均每周为133,181美元，估计每年总费用为690万美元。与甲基苯丙胺相关的急诊患者更可能为男性（优势比[OR]为1.6，95%置信区间[CI]=1.30至2.01）、白人（OR为1.8，95%CI=1.38至2.29）且未参保（OR为3.2，95%CI=2.21至4.69）。与甲基苯丙胺相关就诊病例相关的前四大医疗状况为心理健康问题（18.7%）、创伤（18.4%）、皮肤感染（11.1%）和牙科诊断（9.6%）。
甲基苯丙胺滥用在急诊利用和医院费用中占比虽小但相当可观。与甲基苯丙胺相关的急诊就诊最常与精神疾病、创伤、皮肤及牙科相关问题有关。
