Wani Rajvi J, Wisdom Jennifer P, Wilson Fernando A
a Department of Health Services Research, Administration and Policy, College of Public Health , University of Nebraska Medical Center , Omaha , Nebraska , USA.
b Graduate School of Public Health and Health Policy, Department of Health Policy and Management, Center for Innovation in Mental Health , City University of New York , New York , New York , USA.
Subst Use Misuse. 2019;54(3):482-494. doi: 10.1080/10826084.2018.1517801. Epub 2018 Oct 31.
Annually, 1.8 million New York (NY) residents experience substance use disorders (SUDs). Even though emergency departments (EDs) continue to experience high numbers of SUD-related visits, only 15% receive treatment.
This study estimates hospital-based EDs rates for SUDs in the State of New York. Also, the geographic distribution of substance use treatment centers and EDs are mapped to correlate utilization with access to care.
The 2011-2013 Healthcare Cost and Utilization Project's NY State Emergency Department Database provided information on utilization of services in EDs, charges, diagnoses, and discharge, as well as patient demographic variables. All patients within NY who had visited the ED for SUDs comprised the study population. Geographic mapping of EDs and substance abuse treatment centers at the county-level is based on data from the National Emergency Department Inventory and National Survey of Substance Abuse Treatment Services, respectively.
A total of 492,419 ED visits for SUDs were reported through 2011-2013. Despite NY's Medicaid expansion in 2012, ED visits increased in 2013. About $856 million was spent in treating SUDs in EDs, with average charge of $1,764 per visit. Conclusions/Importance: Alcohol and drug-induced mental disorders are increasingly prevalent in New York's EDs. There is a need to develop health policies and programs to improve access to care for SUDs in urban states.
每年有180万纽约居民患有物质使用障碍（SUDs）。尽管急诊科（EDs）中与物质使用障碍相关的就诊人数持续居高不下，但只有15%的患者接受了治疗。
本研究估算了纽约州医院急诊科中物质使用障碍的发生率。此外，绘制了物质使用治疗中心和急诊科的地理分布图，以关联医疗服务利用情况与就医可及性。
2011 - 2013年医疗成本与利用项目的纽约州急诊科数据库提供了急诊科服务利用、收费、诊断、出院以及患者人口统计学变量等信息。纽约州内所有因物质使用障碍前往急诊科就诊的患者构成了研究人群。县级急诊科和药物滥用治疗中心的地理分布图分别基于国家急诊科库存数据和国家药物滥用治疗服务调查数据绘制。
2011 - 2013年期间，共报告了492,419次因物质使用障碍前往急诊科的就诊。尽管纽约州在2012年扩大了医疗补助范围，但2013年急诊科就诊人数仍有所增加。在急诊科治疗物质使用障碍花费了约8.56亿美元，每次就诊平均费用为1,764美元。结论/重要性：酒精和药物所致精神障碍在纽约州的急诊科中日益普遍。有必要制定卫生政策和项目，以改善城市州中物质使用障碍患者的就医可及性。
