Evidence map›Paper›PMID 28494791›Full record

Observational studyHarm reduction journal2017

A cohort study examining emergency department visits and hospital admissions among people who use drugs in Ottawa, Canada.

Claire E Kendall, Lisa M Boucher, Amy E Mark, Alana Martin, Zack Marshall, Rob Boyd, Pam Oickle, Nicola Diliso, Dave Pineau, Brad Renaud and 5 more

Erratum issuedAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Harm reduction journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 52 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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  4. Syringe Services Participants' Preferences for Wound Care, HIV/Hepatitis C Virus Screening, and Opioid Use Disorder Treatment: A Discrete Choice Experiment.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2026
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  12. Social justice as nursing resistance: a foucauldian discourse analysis within emergency departments.Nursing philosophy : an international journal for healthcare professionals · 2025
    Article
  13. Cost-benefit analysis of Canada's Prison Needle Exchange Program for the prevention of hepatitis C and injection-related infections.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Claire E KendallBruyère Research Institute, 43 Bruyère Street (Annex E), Ottawa, ON, K1N 5C8, Canada. ckendall@uottawa.ca.ORCID 0000-0003-2686-1135
Lisa M BoucherBruyère Research Institute, 43 Bruyère Street (Annex E), Ottawa, ON, K1N 5C8, Canada.
Amy E MarkInstitute for Clinical Evaluative Sciences, Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Box 684, Administrative Services Building, 1st Floor, Ottawa, ON, K1Y 4E9, Canada.
Alana MartinOttawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9, Canada.
Zack MarshallSocial Development Studies and School of Social Work, Renison University College-University of Waterloo, 240 Westmount Road North, Waterloo, ON, N2L 3G4, Canada.
Rob BoydSandy Hill Community Health Centre, 221 Nelson Street, Ottawa, ON, K1N 1C7, Canada.
Pam OickleOttawa Public Health, 179 Clarence St, Ottawa, ON, K1N 5P7, Canada.
Nicola DilisoPROUD Community Advisory Committee, Ottawa, ON, Canada.
Dave PineauPROUD Community Advisory Committee, Ottawa, ON, Canada.
Brad RenaudPROUD Community Advisory Committee, Ottawa, ON, Canada.
Tiffany RosePROUD Community Advisory Committee, Ottawa, ON, Canada.
Sean LeBlancPROUD Community Advisory Committee, Ottawa, ON, Canada.
Mark TyndallBC Centre for Disease Control, 655W 12th Avenue, Vancouver, BC, V5Z 4R4, Canada.
Olivia M LeeFaculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8 L1, Canada.
Ahmed M BayoumiInstitute for Clinical Evaluative Sciences, Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Box 684, Administrative Services Building, 1st Floor, Ottawa, ON, K1Y 4E9, Canada.

Funding

CIHR
6 · The paper itself

Abstract

backgroundThe health of people who use drugs (PWUD) is characterized by multimorbidity and chronicity of health conditions, necessitating an understanding of their health care utilization. The objective of this study was to evaluate emergency department (ED) visits and hospital admissions among a cohort of PWUD.

methodsWe used a retrospective observational design between 2012 and 2013. The population was a marginalized cohort of PWUD (the PROUD study) for whom survey data was linked (n = 663) to provincial health administrative data housed at the Institute for Clinical Evaluative Sciences. We constructed a 5:1 comparison group matched by age, sex, income quintile, and region. The main outcomes were defined as having two or more ED visits, or one or more hospital admissions, in the year prior to survey completion. We used multivariable logistic regression analyses to identify factors associated with these outcomes.

resultsCompared to the matched cohort, PWUD had higher rates of ED visits (rate ratio [RR] 7.0; 95% confidence interval [95% CI] 6.5-7.6) and hospitalization (RR 7.7; 95% CI 5.9-10.0). After adjustment, factors predicting more ED visits were receiving disability (adjusted odds ratio [AOR] 3.0; 95% CI 1.7-5.5) or income assistance (AOR 2.7; 95% CI 1.5-5.0), injection drug use (AOR 2.1; 95% CI 1.3-3.4), incarceration within 12 months (AOR 1.6; 95% CI 1.1-2.4), mental health comorbidity (AOR 2.1; 95% CI 1.4-3.1), and a suicide attempt within 12 months (AOR 2.1; 95% CI 1.1-3.4). Receiving methadone (AOR 0.5; 95% CI 0.3-0.9) and having a regular family physician (AOR 0.5; 95% CI 0.2-0.9) were associated with lower odds of having more ED visits. Factors associated with more hospital admissions included Aboriginal identity (AOR 2.4; 95% CI 1.4-4.1), receiving disability (AOR 2.4; 95% CI 1.1-5.4), non-injection drug use (opioids and non-opioids) (AOR 2.2; 95% CI 1.1-4.4), comorbid HIV (AOR 2.4; 95% CI 1.2-5.6), mental health comorbidity (AOR 2.4; 95% CI 1.3-4.2), and unstable housing (AOR 1.9; 95% CI 1.0-3.4); there were no protective factors for hospitalization.

conclusionsImproved post-incarceration support, housing services, and access to integrated primary care services including opioid replacement therapy may be effective interventions to decrease acute care use among PWUD, including targeted approaches for people receiving social assistance or with mental health concerns.

Indexed as

AdultCanadaCohort StudiesEmergency Service, HospitalFemaleHospitalizationHumansMalePatient Acceptance of Health CareRetrospective StudiesSubstance-Related DisordersEmergency department visitsHealth administrative dataHospital admissionsMatched control groupMultimorbidityOpioid replacement therapyPeople who use drugsPrescription drug benefitsPrimary careSelf-reported data

Identifiers

PMID28494791
PMCPMC5427560

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.