Table 2.
Typology of patients who use emergency departments for mental disorders and substance use disorders: two-step cluster analysis (N = 320)
| Class 1 (n = 74; 23.1%) | Class 2 (n = 66; 20.6%) | Class 3 (n = 90; 28.1%) | Class 4 (n = 90; 28.1%) | Combined (n = 320; 100.0%) | ||
|---|---|---|---|---|---|---|
| Variable of interest | Frequency of visits to the emergency department for MD-SUD, mean (s.d.) | 0.732 (1.41) | 4.6411,3,4 (7.00) | 1.142 (1.82) | 1.212 (1.32) | 1.79 (3.74) |
| Predisposing | Age categories, n (%) | |||||
| 18–29 years | 35 (39.3) | 21 (23.6) | 30 (33.7) | 3 (3.4) | 89 (100.0) | |
| 30–44 years | 24 (18.3) | 32 (24.4) | 56 (42.7) | 19 (14.5) | 131 (100.0) | |
| ≥45 years | 153,4 (15.0) | 133,4 (13.0) | 41,2 (4.0) | 681,2 (68.0) | 100 (100.0) | |
| Gender, n (%) | ||||||
| Female | 12 (7.3) | 31 (18.8) | 67 (40.6) | 55 (33.3) | 165 (100.0) | |
| Male | 622,3,4 (40.0) | 351,3,4 (22.6) | 231,2,4 (14.8) | 351,2,3 (22.6) | 155 (100.0) | |
| Education, n (%) | ||||||
| High school | 46 (32.6) | 27 (19.1) | 24 (17.0) | 44 (31.2) | 141 (100.0) | |
| Post-secondary | 282,3 (15.6) | 391,3 (21.8) | 661,2,4 (36.9) | 463 (25.7) | 179 (100.0) | |
| Employed, n (%) | 182,3 (16.8) | 71,3 (6.5) | 701,2,4 (65.4) | 123 (11.2) | 107 (100.0) | |
| Household income, n (%) | ||||||
| <Can$21 000/year | 48 (34.0) | 43 (30.5) | 9 (6.4) | 41 (29.1) | 141 (100.0) | |
| Can$21 000–50 000/year | 25 (20.3) | 17 (13.8) | 52 (42.3) | 29 (23.6) | 123 (100.0) | |
| >Can$50 000/year | 13,4 (1.8) | 613,4 (10.7) | 291,2,4 (51.8) | 201,2,4 (35.7) | 56 (100.0) | |
| Enabling | Regular source of care, n (%) | |||||
| Has a family physician | 223,4 (10.6) | 293,4 (14.0) | 771,2 (37.2) | 791,2 (38.2) | 207 (100.0) | |
| Has a psychiatrist | 202,4 (13.9) | 591,3,4 (41.0) | 21,2 (18.8) | 381,2 (26.4) | 144 (100.0) | |
| Outcomes, mean (s.d.) | ||||||
| Frequency of hospital admission for MD-SUDa | 0.362,4 (0.61) | 2.111,3,4 (2.08) | 0.472 (0.89) | 0.711,2 (0.78) | 0.85 (1.34) | |
| Frequency of visits to a general practitioner for MD-SUDa | 0.243,4 (0.77) | 0.613 (1.29) | 1.861,2 (3.11) | 1.301 (2.24) | 1.07 (2.23) | |
| Frequency of visits to a psychiatrist for MD-SUDa | 4.072 (10.53) | 22.261,3 (22.67) | 2.212,4 (4.49) | 6.772,3 (12.30) | 8.06 (15.28) | |
| Needs | Number of chronic physical illnesses, mean (s.d.) | 0.164 (0.41) | 0.48 (0.92) | 0.244 (0.50) | 0.861,3 (1.02) | 0.45 (0.81) |
| DAST-20 score ≥6, n (%) | 313,4 (34.4) | 343,4 (37.8) | 191,2,4 (21.1) | 61,2,3 (6.7) | 90 (100.0) | |
| AUDIT score ≥8, n (%) | 412,3,4 (41.8) | 231,4 (23.5) | 271,4 (27.6) | 71,2,3 (7.1) | 98 (100.0) | |
| Anxiety, n (%) | 02,3,4 (0.0) | 321,4 (32.7) | 371 (37.8) | 291,2 (29.6) | 98 (100.0) | |
| Depression, n (%) | 12,3,4 (0.7) | 561,3,4 (38.4) | 471,2 (32.2) | 421,2 (28.8) | 146 (100.0) | |
| Schizophrenia, n (%) | 232,3 (24.2) | 321,3 (33.7) | 71,2,4 (7.4) | 333 (34.7) | 95 (100.0) | |
| Bipolar disorder, n (%) | 12,3,4 (1.7) | 241,3 (40.0) | 121,2,4 (20.0) | 231,3 (38.3) | 60 (100.0) | |
| Personality disorder, n (%) | 42,3 (8.0) | 181,4 (36.0) | 161 (32.0) | 122 (24.0) | 50 (100.0) | |
The number in superscript indicates with which class the variable is significantly different. Class 1: individuals with moderate emergency department use and low use of other health services; mostly young, economically disadvantaged males with substance use disorders. Class 2: individuals with high emergency department and specialized health service use, with multiple MD-SUD. Class 3: Middle-aged, economically advantaged females with common mental disorders, who made moderate use of emergency departments but consulted general practitioners. Class 4: Older individuals with multiple chronic physical illnesses co-occurring with mental disorders, who made moderate use of the emergency department, but mainly consulted general practitioners.
MD-SUD, mental and substance use disorders; DAST-20, Drug Abuse Screening Test-20; AUDIT, Alcohol Use Disorders Identification Test.
In the previous 12 months.