National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
Drug Alcohol Rev. 2018 Feb;37(2):196-204. doi: 10.1111/dar.12518. Epub 2017 Mar 12.
We estimated health service utilisation attributable to methamphetamine use, its national impact and examined other predictors of health service utilisation among dependent methamphetamine users.
Past year rates of health service utilisation (number of attendances for general hospitals, psychiatric hospitals, emergency departments, general practitioners, psychiatrists, counsellors or psychologists, and dentists) were estimated for three levels of methamphetamine use (no use, < weekly, ≥ weekly) using panel data from a longitudinal cohort of 484 dependent methamphetamine users from Sydney and Brisbane, Australia. Marginal rates for methamphetamine use were multiplied by 2013 prevalence estimates from the National Drug Strategy Household Survey. Covariates included other substance use, demographics, mental disorders and drug treatment.
Health service use was high. More frequent methamphetamine use was associated with more frequent presentations to emergency departments (incidence rate ratios 1.3-2.1) and psychiatric hospitals (incidence rate ratios 5.3-8.3) and fewer presentations to general practitioners, dentists and counsellors. We estimate methamphetamine use accounted for between 28 400 and 80 900 additional psychiatric hospital admissions and 29 700 and 151 800 additional emergency department presentations in 2013. More frequent presentations to these services were also associated with alcohol and opioid use, comorbid mental health disorders, unemployment, unstable housing, attending drug treatment, low income and lower education.
Frequent methamphetamine use has a significant impact on emergency medical and psychiatric services. Better provision of non-acute health care services to address the multiple health and social needs of dependent methamphetamine users may reduce the burden on these acute care services. [McKetin R, Degenhardt L, Shanahan M, Baker AL, Lee NK, Lubman DI. Health service utilisation attributable to methamphetamine use in Australia: patterns, predictors and national impact. Drug Alcohol Rev 2017;00:000-000].
我们评估了与甲基苯丙胺使用相关的卫生服务利用情况、其对全国的影响，并研究了其他因素对依赖甲基苯丙胺使用者卫生服务利用的预测作用。
利用来自澳大利亚悉尼和布里斯班的纵向队列 484 名依赖甲基苯丙胺使用者的面板数据，对三种水平的甲基苯丙胺使用（未使用、<每周、≥每周）的过去一年卫生服务利用（去综合医院、精神病医院、急诊部、全科医生、精神科医生、顾问或心理学家和牙医就诊次数）的发生率进行了估计。将甲基苯丙胺使用的边际率乘以 2013 年全国毒品策略家庭调查的流行率估计值。协变量包括其他物质使用、人口统计学因素、精神障碍和药物治疗。
卫生服务利用率很高。更频繁的甲基苯丙胺使用与更频繁地去急诊部（发病率比 1.3-2.1）和精神病院（发病率比 5.3-8.3）就诊以及更少地去全科医生、牙医和顾问有关。我们估计，2013 年，甲基苯丙胺使用导致了 28400 至 80900 例额外的精神病院入院和 29700 至 151800 例额外的急诊就诊。这些服务中更频繁的就诊也与酒精和阿片类药物使用、合并精神健康障碍、失业、住房不稳定、接受药物治疗、低收入和低教育程度有关。
频繁的甲基苯丙胺使用对急诊医疗和精神科服务有重大影响。为满足依赖甲基苯丙胺使用者的多种健康和社会需求，更好地提供非急性保健服务，可能会减轻这些急性保健服务的负担。
