Rooney Brenda L, Voter Mitchell T, Eberlein Christopher M, Schossow Andrea J, Fischer Cathy L
Department of Community and Preventive Care Services, Gundersen Health System, La Crosse, Wisconsin.
Department of Emergency Services, Gundersen Health System, La Crosse, Wisconsin.
WMJ. 2018 Mar;117(1):18-23.
Drug use and drug overdose have increased at an alarming rate.
To identify demographic and neighborhood social and economic factors associated with higher risk of overdose. These findings can be used to inform development of community programs and appropriately devote resources to prevent and treat drug abuse.
The electronic health records of all patients seen in the emergency department or admitted to the hospital for a drug overdose in 2016 at Gundersen Health System in La Crosse, Wisconsin, were reviewed retrospectively. Patient data collected included age, sex, race/ethnicity, insurance type, overdose intention (intentional, unintentional), drug involved, and total charge for the episode of care. Patient residence was geocode mapped to census tract to analyze the relationship of drug overdose to neighborhood characteristics. Overdose rates were calculated by census tract and compared by several sociodemographic characteristics.
Four hundred nineteen patients were included in this study. Forty percent of overdoses were unintentional. Patients who were older, male, nonwhite, and who had no insurance were more likely to have unintentional overdoses. Opiates and heroin were most commonly present in unintentional overdoses, whereas benzodiazepines and sedatives were more common in intentional overdoses. Patients living in census tracts with a higher percentage of residents with some college also had a higher rate of unintentional overdose. Rates of overdose at the census tract level varied and were higher in tracts with lower median income, low income inequality ratio, high percentage of college attendance, and higher percentage of nonwhite residents. The average charge per overdose was $14,771 (median = $9,497) and totaled $6,188,923 for the year.
This study provides demographic, geographic, and socioeconomic detail about drug overdose in the community that can be used to focus future treatment and prevention interventions.
药物使用和药物过量现象正以惊人的速度增长。
确定与药物过量高风险相关的人口统计学、社区社会和经济因素。这些研究结果可用于指导社区项目的开展,并合理分配资源以预防和治疗药物滥用。
对2016年在威斯康星州拉克罗斯市冈德森医疗系统因药物过量而在急诊科就诊或住院的所有患者的电子健康记录进行回顾性审查。收集的患者数据包括年龄、性别、种族/民族、保险类型、过量用药意图(故意、非故意)、涉及的药物以及此次护理事件的总费用。将患者居住地进行地理编码映射到普查区,以分析药物过量与社区特征之间的关系。按普查区计算过量用药率,并按若干社会人口统计学特征进行比较。
本研究纳入了419名患者。40%的过量用药为非故意的。年龄较大、男性、非白人且没有保险的患者更有可能非故意过量用药。阿片类药物和海洛因在非故意过量用药中最为常见,而苯二氮䓬类药物和镇静剂在故意过量用药中更为常见。居住在有一定大学学历居民比例较高的普查区的患者非故意过量用药率也较高。普查区层面的过量用药率各不相同,在收入中位数较低、收入不平等率较低、大学入学率较高以及非白人居民比例较高的区域更高。每次过量用药的平均费用为14,771美元(中位数 = 9,497美元),当年总计6,188,923美元。
本研究提供了社区中药物过量的人口统计学、地理和社会经济细节,可用于指导未来的治疗和预防干预措施。