Table 3.
Hospitalization and healthcare utilization characteristics of subgroups of people with frequent ED visits (top 10%) and substance use in Ontario, Alberta, and B.C. (April 1st, 2014 to March 31st, 2015)
| Characteristics | Ontario | Alberta | B.C | |||
|---|---|---|---|---|---|---|
| Hospitalization Characteristics (DAD) | ||||||
| Extreme (N = 2,669) | Moderate (N = 16,921) | Extreme (N = 1,468) | Moderate (N = 6,220) | Extreme (N = 1,690) | Moderate (N = 7,713) | |
| Number of patients with at least one admission, n (%) | 1,444 (54.1) | 6,873 (40.6) | 1,068 (72.8) | 3,425 (55.1) | 1,374 (81.3) | 4,756 (61.7) |
| Number of admissions per patient | ||||||
| Median (IQR) | 2 (1–4) | 1 (1–2) | 2 (1–5) | 2 (1–3) | 3 (2–5) | 2 (1–3) |
| Number of admissions (for any reason) | 4,498 | 13,648 | 3,647 | 6,981 | 5,499 | 10,446 |
| Total length of stay among admissions (days) | ||||||
| Median (IQR) | 2 (1–5) | 3 (2–7) | 3 (2–7) | 4 (2–9) | 3 (1–6) | 3 (1–8) |
| Disposition group among admissions, n (%) | ||||||
| Transferred | 656 (14.6) | 2,157 (15.8) | 279 (7.7) | 699 (10) | 493 (9.0) | 1,052 (10.1) |
| Discharged | 3,203 (71.2) | 10,282 (75.3) | 2,756 (75.6) | 5,547 (79.5) | 4,163 (75.7) | 8,302 (79.5) |
| Signed out (against medical advice) | 621 (13.8) | 927 (6.8) | 586 (16.1) | 639 (9.2) | 807 (14.7) | 961 (9.2) |
| Died | 18 (0.4) | 280 (2.1) | 22 (0.6) | 84 (1.2) | 25 (0.5) | 99 (0.9) |
| Did not return from pass | 0 (0.0) | 2 (0.0) | 4 (0.1) | 12 (0.2) | 11 (0.2) | 32 (0.3) |
| NA | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Substance-related diagnostic categories among admissions, n (%) | ||||||
| Alcohol | 1,108 (24.6) | 3,891 (28.5) | 1,084 (29.7) | 1,951 (27.9) | 1,415 (25.7) | 2,177 (20.8) |
| Other substances | 417 (9.3) | 1,340 (9.8) | 427 (11.7) | 844 (12.1) | 901 (16.4) | 1,841 (17.6) |
| Non substance-related admission | 2,973 (66.1) | 8,417 (61.7) | 2,136 (58.6) | 4,186 (60) | 3,183 (57.9) | 6,428 (61.5) |
| Top 3 primary diagnosis among admissions, n (%) | ||||||
| 1 |
Mental and behavioural disorders due to use of alcohol, withdrawal state (F103): 477 (10.6) |
Mental and behavioural disorders due to use of alcohol, withdrawal state (F103): 1,029 (7.5) |
Mental and behavioural disorders due to use of alcohol, withdrawal state (F103): 462 (12.7) |
Mental and behavioural disorders due to use of alcohol, withdrawal state (F103): 558 (8.0) |
Mental and behavioural disorders due to use of alcohol, withdrawal state (F103): 504 (9.2) |
Mental and behavioural disorders due to use of alcohol, withdrawal state (F103): 613 (5.9) |
| 2 |
Mental and behavioural disorders due to use of alcohol, acute intoxication (F100): 164 (3.6) |
Alcohol-induced acute pancreatitis (K852): 648 (4.7) |
Mental and behavioural disorders due to use of alcohol, dependence syndrome (F102): 109 (3.0) |
Alcohol-induced acute pancreatitis (K852): 230 (3.3) |
Mental and behavioural disorders due to use of alcohol, acute intoxication (F100): 259 (4.7) |
Mental and behavioural disorders due to use of alcohol, acute intoxication (F100): 331 (3.2) |
| 3 |
Poisoning by benzodiazepines (T424): 99 (2.2) |
Alcoholic cirrhosis of liver (K703): 588 (4.3) |
Mental and behavioural disorders due to use of alcohol, acute intoxication (F100): 90 (2.5) |
Mental and behavioural disorders due to use of alcohol, dependence syndrome (F102): 226 (3.2) |
Mental and behavioural disorders due to use of other stimulants including caffeine, psychotic disorder (F155): 210 (3.8) |
Mental and behavioural disorders due to use of other stimulants including caffeine, psychotic disorder (F155): 306 (2.9) |
| Mental Health Admission Characteristics (HMHDB) | ||||||
| Extreme (N = 2,669) | Moderate (N = 16,921) | Extreme (N = 1,468) | Moderate (N = 6,220) | Extreme (N = 1,690) | Moderate (N = 7,713) | |
| Number of patients with at least one mental health admission, n (%) | 1,405 (52.6) | 6,054 (35.8) | 695 (47.3) | 1,849 (29.7) | NA | NA |
| Number of mental health admissions per patient | ||||||
| Median (IQR) | 2 (1–4) | 1 (1–2) | 2 (1–3) | 1 (1–2) | NA | NA |
| Homelessness among patients with at least one admission, n (%) | ||||||
| No | 1,197 (85.2) | 5,770 (95.3) | 553 (79.6) | 1,720 (93.0) | NA | NA |
| Yes | 208 (14.8) | 284 (4.7) | 142 (20.4) | 129 (7.0) | NA | NA |
| Number of mental health admissions (for any reason) | 4,294 | 10,229 | 1,605 | 2,876 | NA | NA |
| Discharge disposition among mental health admissions, n (%)* | ||||||
| Discharged Home | 3,191 (74.3) | 8,553 (83.6) | 1,200 (74.8) | 2,305 (80.1) | NA | NA |
| Transferred | 286 (6.7) | 757 (7.4) | 106 (6.6) | 248 (8.6) | NA | NA |
| Died | 0 (0.0) | 4 (0.0) | 0 (0.0) | 3 (0.1) | NA | NA |
| Sign-out | 276 (6.4) | 347 (3.4) | 299 (18.6) | 320 (11.1) | NA | NA |
| Other | 541 (12.6) | 568 (5.6) | 0 (0.0) | 0 (0.0) | NA | NA |
| Diagnostic categories among mental health admissions, n (%) | ||||||
| Organic Disorders | 31 (0.7) | 164 (1.6) | 9 (0.6) | 56 (1.9) | NA | NA |
| Substance Related Disorders | 2,220 (51.7) | 5,517 (53.9) | 1162 (72.4) | 1,891 (65.8) | NA | NA |
| Schizophrenic and Psychotic Disorders | 665 (15.5) | 1,340 (13.1) | 110 (6.9) | 276 (9.6) | NA | NA |
| Mood Disorders | 679 (15.8) | 2,123 (20.8) | 125 (7.8) | 305 (10.6) | NA | NA |
| Anxiety Disorders | 108 (2.5) | 258 (2.5) | 17 (1.1) | 72 (2.5) | NA | NA |
| Personality Disorders | 392 (9.1) | 316 (3.1) | 78 (4.9) | 65 (2.3) | NA | NA |
| Other Mental Health Disorders | 185 (4.3) | 468 (4.6) | 103 (6.4) | 207 (7.2) | NA | NA |
| Unknown Disorders | 1 (0.0) | 6 (0.1) | 0 (0.0) | 0 (0.0) | NA | NA |
| Non-Mental Health Disorder | 13 (0.3) | 37 (0.4) | 1 (0.1) | 4 (0.1) | NA | NA |
| Other Healthcare Utilization Characteristics (MSP and Pharmanet) | ||||||
| Extreme (N = 2,669) | Moderate (N = 16,921) | Extreme (N = 1,468) | Moderate (N = 6,220) | Extreme (N = 1,690) | Moderate (N = 7,713) | |
| MSP Long-term care, n (%) | ||||||
| No | NA | NA | NA | NA | 1,655 (97.9) | 7,278 (94.4) |
| Yes | NA | NA | NA | NA | 13 (0.8) | 63 (0.8) |
| NA | NA | NA | NA | NA | 22 (1.3) | 372 (4.8) |
| MSP number of general practitioner visits | ||||||
| Median (IQR) | NA | NA | NA | NA | 53 (26–97) | 28 (13–55) |
| MSP number of individual general practitioners | ||||||
| Median (IQR) | NA | NA | NA | NA | 14 (7–30) | 12 (6–25) |
| MSP Majority source of care, n (%) | ||||||
| Yes | NA | NA | NA | NA | 389 (23.0) | 3,010 (39.0) |
| No | NA | NA | NA | NA | 1,279 (75.7) | 4,331 (56.2) |
| 0 GP visit | NA | NA | NA | NA | 22 (1.3) | 372 (4.8) |
| Number of prescription medications based on DINPIN | ||||||
| Median (IQR) | NA | NA | NA | NA | 26 (16–39) | 19 (11–29) |