TY - JOUR
T1 - Emergency Department Visits in a Cohort of Persons with Substance Use
T2 - Incorporating the Role of Social Networks
AU - Sacamano, Paul
AU - Krawczyk, Noa
AU - Latkin, Carl
N1 - Funding Information:
This work was supported by the National Institute on Drug Abuse (grant no. 5R01DA022961).
Publisher Copyright:
© 2018, © 2018 Taylor & Francis Group, LLC.
PY - 2018/11/10
Y1 - 2018/11/10
N2 - Background: Frequent emergency department (ED) visits often suggest inappropriate use for low acuity needs and multiple comorbidities, including substance use disorders. Objective: This study examines associations of individuals and their social networks with high frequency ED use among persons reporting substance use. Methods: Information was obtained from interview responses from the first 6-month follow-up visit of a longitudinal. Prevalence ratios for the outcome of high frequency ED visits (≥2 in 6 months) were determined with a generalized linear model, log link, Poisson distribution and robust standard errors. Results: Of 653 participants, 131 (20%) had ≥2 ED visits. In multivariable analysis, greater likelihood of high frequency ED visits over 6 months was associated with being homeless (PR: 1.58; 95% CI: 1.19, 2.10), taking ≥3 medications (PR: 1.58; 95% CI: 1.19, 2.10) and having had a hospitalization over the same period (PR: 4.33; 95% CI: 3.26, 7.56). Among social network factors, lower likelihood of high frequency visits was associated with each increasing year of mean alter age (PR: 0.98; 95% CI: 0.6, 0.99) and greater likelihood with having received health-related informational support from ≥2 alters (PR: 1.62; 95% CI: 1.04, 2.53). Conclusions/Importance: Social network factors may play an important role in ED use. Interventions to promote health behaviors through social influence may be helpful in reducing high frequency ED visits.
AB - Background: Frequent emergency department (ED) visits often suggest inappropriate use for low acuity needs and multiple comorbidities, including substance use disorders. Objective: This study examines associations of individuals and their social networks with high frequency ED use among persons reporting substance use. Methods: Information was obtained from interview responses from the first 6-month follow-up visit of a longitudinal. Prevalence ratios for the outcome of high frequency ED visits (≥2 in 6 months) were determined with a generalized linear model, log link, Poisson distribution and robust standard errors. Results: Of 653 participants, 131 (20%) had ≥2 ED visits. In multivariable analysis, greater likelihood of high frequency ED visits over 6 months was associated with being homeless (PR: 1.58; 95% CI: 1.19, 2.10), taking ≥3 medications (PR: 1.58; 95% CI: 1.19, 2.10) and having had a hospitalization over the same period (PR: 4.33; 95% CI: 3.26, 7.56). Among social network factors, lower likelihood of high frequency visits was associated with each increasing year of mean alter age (PR: 0.98; 95% CI: 0.6, 0.99) and greater likelihood with having received health-related informational support from ≥2 alters (PR: 1.62; 95% CI: 1.04, 2.53). Conclusions/Importance: Social network factors may play an important role in ED use. Interventions to promote health behaviors through social influence may be helpful in reducing high frequency ED visits.
KW - Emergency department use
KW - ego networks
KW - social support
KW - substance use
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U2 - 10.1080/10826084.2018.1461225
DO - 10.1080/10826084.2018.1461225
M3 - Comment/debate
C2 - 29671696
AN - SCOPUS:85045733861
SN - 1082-6084
VL - 53
SP - 2265
EP - 2269
JO - Substance Use and Misuse
JF - Substance Use and Misuse
IS - 13
ER -