Author:
Ali Shawkut,Lowe Shona,George James S.,Brown Christopher,Sanchez Gloria,Pendergraph Bernadette
Abstract
Objectives: The purpose of this study was to describe the emergency department (ED) visit chief complaints and discharge diagnoses of patients with an opioid use disorder (OUD) empaneled to a primary care clinic.
Design: ED visits were retrospectively reviewed through electronic health records. Patients with a history of using multiple substances and medical or psychiatric conditions were compared to those without these conditions.
Setting: This study was conducted at Harbor-UCLA ED, a safety-net level one trauma center.
Patients and participants: Eligible participants were empaneled to the Harbor-UCLA Family Health Center with a diagnosis of OUD between January 1, 2018, and December 31, 2020.
Main outcome measures: The primary outcome measures included number of ED visits, hospital admissions, chief complaints, and discharge diagnoses.
Results: The total number of patients was 59. The most common chief complaints were musculoskeletal (34 percent), gastrointestinal (18 percent), general (13 percent), and skin (8.6 percent). The most common discharge diagnoses were musculoskeletal (27 percent), gastrointestinal (20 percent), infectious (11 percent), substance use disorder related (11 percent), psychiatric (7 percent), and cardiovascular (7 percent). Co-occurring alcohol use was associated with a higher number of visits, 3.18 versus 1.15 (p = 0.021), and a higher percentage of patients with frequent visits, 46 percent versus 8 percent (p = 0.008). Patients with diabetes had more frequent visits, 40 percent versus 10 percent (p = 0.036), and were more likely to be admitted, 43 percent versus 15 percent (p = 0.010).
Conclusions: This study highlights the importance of screening and the management of alcohol use and diabetes among patients with OUD.
Publisher
Weston Medical Publishing
Subject
Anesthesiology and Pain Medicine,Pharmacology (medical),General Medicine
Reference26 articles.
1. Moore B, Liang L: Costs of emergency department visits in the United States. Agency for Healthcare Research and Quality. 2017. Available at www.hcup-us.ahrq.gov/reports/statbriefs/sb268-ED-Costs-2017.pdf. Accessed October 10, 2022.
2. National Institute on Drug Abuse: Part 1: The connection between substance use disorders and mental illness. 2020. Available at https://www.drugabuse.gov/publications/researchreports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness. Accessed January 10, 2021.
3. National Institute on Drug Abuse: Part 2: Co-occurring substance use disorder and physical comorbidities. 2020. Available at https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-2-cooccurring-substance-use-disorder-physical-comorbidities. Accessed January 10, 2021.
4. Choi S, Biello KB, Bazzi AR, et al.: Age differences in emergency department utilization and repeat visits among patients with opioid use disorder at an urban safety-net hospital: A focus on young adults. Drug Alcohol Depend. 2019; 200: 14-18. DOI: 10.1016/j.drugalcdep.2019.02.030.
5. Bahorik AL, Satre DD, Kline-Simon AH, et al.: Alcohol, marijuana, and opioid use disorders: 5-Year patterns and characteristics of emergency department encounters. Subst Abus. 2018; 39(1): 59-68. DOI: 10.1080/08897077.2017.1356789.