Evidence map›Paper›PMID 38549074›Full record

Observational studyHarm reduction journal2024

Association of hospital-based substance use supports on emergency department revisits: a retrospective cohort study in Sudbury, Canada from 2018 to 2022.

Mark Tatangelo, Russell Landry, Denis Beaulieu, Catherine Watson, Shannon Knowlan, Alex Anawati, Adele Bodson, Natalie Aubin, David C Marsh, Tara Leary and 1 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Harm reduction journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mark TatangeloHealth Science North, Sudbury, ON, Canada.
Russell LandryHealth Science North, Sudbury, ON, Canada.
Denis BeaulieuHealth Science North, Sudbury, ON, Canada.
Catherine WatsonHealth Science North, Sudbury, ON, Canada.
Shannon KnowlanHealth Science North, Sudbury, ON, Canada.
Alex AnawatiHealth Science North, Sudbury, ON, Canada.
Adele BodsonHealth Science North, Sudbury, ON, Canada.
Natalie AubinHealth Science North, Sudbury, ON, Canada.
David C MarshHealth Science North, Sudbury, ON, Canada.
Tara LearyHealth Science North, Sudbury, ON, Canada.
Kristen A MorinHealth Science North, Sudbury, ON, Canada. kmorin@nosm.ca.

Funding

Northern Ontario Academic Medicine Association AFP Innovation Fund A-22-18
6 · The paper itself

Abstract

backgroundThis study compares emergency department (ED) revisits for patients receiving hospital-based substance-use support compared to those who did not receive specialized addiction services at Health Sciences North in Sudbury, Ontario, Canada.

methodsThe study is a retrospective observational study using administrative data from all patients presenting with substance use disorder (SUD) at Health Sciences North from January 1, 2018, and August 31, 2022 with ICD-10 codes from the Discharge Abstract Database (DAD) and the National Ambulatory Care Database (NACRS). There were two interventions under study: addiction medicine consult services (AMCS group), and specialized addiction medicine unit (AMU group). The AMCS is a consult service offered for patients in the ED and those who are admitted to the hospital. The AMU is a specialized inpatient medical unit designed to offer addiction support to stabilize patients that operates under a harm-reduction philosophy. The primary outcome was all cause ED revisit within 30 days of the index ED or hospital visit. The secondary outcome was all observed ED revisits in the study period. Kaplan-Meier curves were used to measure the proportion of 30-day revisits by exposure group. Odds ratios and Hazard Ratios were calculated using logistic regression models with random effects and Cox-proportional hazard model respectively.

resultsA total of 5,367 patients with 10,871 ED index visits, and 2,127 revisits between 2018 and 2022 are included in the study. 45% (2,340/5,367) of patient were not admitted to hospital. 30-day revisits were less likely among the intervention group: Addiction Medicine Consult Services (AMCS) in the ED significantly reduced the odds of revisits (OR 0.53, 95% CI 0.39-0.71, p < 0.01) and first revisits (OR 0.42, 95% CI 0.33-0.53, p < 0.01). The AMU group was associated with lower revisits odds (OR 0.80, 95% CI 0.66-0.98, p = 0.03). For every additional year of age, the odds of revisits slightly decreased (OR 0.99, 95% CI 0.98-1.00, p = 0.01) and males were found to have an increased risk compared to females (OR 1.50, 95% CI 1.35-1.67, p < 0.01).

interpretationWe observe statistically significant differences in ED revisits for patients receiving hospital-based substance-use support at Health Sciences North. Hospital-based substance-use supports could be applied to other hospitals to reduce 30-day revisits.

Indexed as

Patient ReadmissionSubstance-Related DisordersEmergency Service, HospitalFemaleHospitalsHumansMaleOntarioRetrospective StudiesAddiction consult teamsAddiction medicineAdministrative dataCohort studyEmergency department revisitsHarm-reductionObservational dataSubstance use disorders

Identifiers

PMID38549074
PMCPMC10976798

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Registered trials

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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.