Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia.
Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, Wollongong, Australia.
Subst Abus. 2022;43(1):1126-1138. doi: 10.1080/08897077.2022.2060427.
: This study aimed to investigate the longitudinal changes in emergency department (ED) presentations incurred by patients with alcohol use disorders. : A retrospective quantitative analysis was conducted on patients' ED presentations between December 2011 and January 2019 in an Australian regional health district. The health district has five EDs serving rural, regional, and metropolitan areas. Patients with alcohol use disorders were divided into two groups for comparison: those who had interactions with the community-based Drug and Alcohol (D&A) services and those who did not. : A total of 2,519 individual patients with alcohol use disorders made 21,715 ED presentations. Among these patients, 75.4% did not have interactions with the community-based D&A services. Compared with those who had, these patients were older, more likely to be diagnosed with abdominal pain (26.9% 12.0%, < 0.001) and chest pain (16.2% 8.6%, < 0.001), and had longer mean length of ED stay (7 hours and 41.7 minutes 6 hours and 25.6 minutes, < 0.001). For the patients who had interactions with the community-based D&A services, their 28-day re-presentation rates decreased from 55.5% (2013-14) to 45.1% (2017-18); however, were higher than that of those who had no interactions (41.1% to 32.8%). Overall, 21.9%-24.5% of the patients were frequent ED presenters (i.e., ≥4 visits per year). Frequent ED presenters were proportionately higher among the patients who had interactions with the community-based D&A services, consistently over the relevant years. Although patients with alcohol use disorders frequently presented to EDs, their alcohol use disorders were only identified in 8.9% of their presentations. : Patients with alcohol use disorders were often unidentified in EDs. Those who did not have interactions with the community-based D&A services were less likely to be diagnosed with alcohol use disorders when presenting to EDs.
: 本研究旨在探讨患有酒精使用障碍的患者在急诊科（ED）就诊的纵向变化。 : 对 2011 年 12 月至 2019 年 1 月期间在澳大利亚地区卫生区接受 ED 治疗的患者进行回顾性定量分析。该卫生区有 5 个 ED，为农村、地区和大都市地区提供服务。将患有酒精使用障碍的患者分为两组进行比较：与社区毒品和酒精（D&A）服务有互动的患者和没有互动的患者。 : 共有 2519 名患有酒精使用障碍的个体患者进行了 21715 次 ED 就诊。其中，75.4%的患者没有与社区毒品和酒精（D&A）服务互动。与有互动的患者相比，这些患者年龄更大，更有可能被诊断为腹痛（26.9% 比 12.0%，<0.001）和胸痛（16.2% 比 8.6%，<0.001），并且 ED 停留的平均时间更长（7 小时和 41.7 分钟 比 6 小时和 25.6 分钟，<0.001）。对于与社区毒品和酒精（D&A）服务有互动的患者，他们的 28 天再就诊率从 2013-14 年的 55.5%下降到 2017-18 年的 45.1%；然而，高于没有互动的患者（41.1%到 32.8%）。总体而言，21.9%-24.5%的患者是频繁的 ED 就诊者（即每年就诊≥4 次）。在有互动的患者中，频繁的 ED 就诊者比例较高，在相关年份中一直如此。尽管患有酒精使用障碍的患者经常到 ED 就诊，但他们的酒精使用障碍仅在其就诊的 8.9%中被识别。 : 在 ED 中，经常有酒精使用障碍患者未被识别。当没有与社区毒品和酒精（D&A）服务互动的患者在 ED 就诊时，他们更不可能被诊断为酒精使用障碍。
