High Users of Emergency Departments in Quebec among Patients with Both Schizophrenia and a Substance Use Disorder
André Ngamini-Ngui, Ph.D.; Marie-Josée Fleury, Ph.D.; Jocelyne Moisan, Ph.D.; Jean-Pierre Grégoire, Ph.D.; Alain Lesage, M.D.; Alain Vanasse, M.D., Ph.D.
The study assessed factors associated over time with high use of emergency departments by patients in Quebec who had schizophrenia and a co-occurring substance use disorder.
The cohort study included 2,921 patients who received a diagnosis of schizophrenia in 2006 and had at least one emergency department visit during fiscal year 2006–2007. Generalized estimating equations were used to estimate predictors of high use of emergency departments over time.
After adjustment for all covariates, predictors of high use over time were as follows: living in either a university medical region (OR=2.10) or a peripheral medical region (OR=2.10), frequent hospitalization (OR=1.16), and greater number of psychiatric (OR=1.64) or physical comorbidities (OR=1.23).
Because high use of emergency departments is a strong indicator of poor care continuity, identified associated factors could help develop and offer new programs to be deployed in the community to better support these patients with greater needs.