Manuel Jennifer I, Lee Jane
New York University Silver School of Social Work, 1 Washington Square North, New York, NY, 10003, USA.
University of Washington School of Social Work, Seattle, WA, USA.
Subst Abuse Treat Prev Policy. 2017 May 30;12(1):28. doi: 10.1186/s13011-017-0114-5.
Drug use-related visits to the emergency department (ED) can undermine discharge planning and lead to recurrent use of acute services. Yet, little is known about where patients go post discharge. We explored trends in discharge dispositions of drug-involved ED visits, with a focus on gender differences.
We extracted data from the 2004-2011 Drug Abuse Warning Network, a national probability sample of drug-related visits to hospital EDs in the U.S. We computed weighted multinomial logistic regression models to estimate discharge dispositions over time and to examine associations between gender and the relative risk of discharge dispositions, controlling for patient characteristics.
The final pooled sample included approximately 1.2 million ED visits between 2004 and 2011. Men accounted for more than half (57.6%) of all ED visits involving drug misuse and abuse. Compared with women, men had a greater relative risk of being released to the police/jail, being referred to outpatient detox or other treatment, and leaving against medical advice than being discharged home. The relative risk of being referred to outpatient detox/drug treatment than discharged home increased over time for men versus women.
Greater understanding of gender-based factors involved in substance-related ED visits and treatment needs may inform discharge planning and preventive interventions.
因吸毒相关问题前往急诊科就诊可能会破坏出院计划，并导致急性服务的反复使用。然而，对于患者出院后去向知之甚少。我们探讨了涉及毒品的急诊科就诊出院处置的趋势，重点关注性别差异。
我们从2004 - 2011年药物滥用预警网络中提取数据，该网络是美国医院急诊科与毒品相关就诊情况的全国概率样本。我们计算加权多项逻辑回归模型，以估计随时间推移的出院处置情况，并在控制患者特征的情况下，研究性别与出院处置相对风险之间的关联。
最终汇总样本包括2004年至2011年间约120万次急诊科就诊。在所有涉及药物滥用和误用的急诊科就诊中，男性占一半以上（57.6%）。与女性相比，男性被送交警察/监狱、被转介至门诊戒毒或其他治疗以及擅自离院的相对风险高于出院回家。随着时间的推移，男性被转介至门诊戒毒/药物治疗而非出院回家的相对风险相对于女性有所增加。
更深入了解与物质相关的急诊科就诊和治疗需求中涉及的基于性别的因素，可能为出院计划和预防性干预提供信息。
