Can Emergency Department, Hospital Discharge, and Death Data Be Used to Monitor Burden of Drug Overdose in Rhode Island?
Can Emergency Department, Hospital Discharge, and Death Data Be Used to Monitor Burden of Drug Overdose in Rhode Island?
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DOI：
10.1097/phh.0000000000000514
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发表时间：
2017-09-01
影响因子：
3.3
通讯作者：
Alexander-Scott, Nicole
中科院分区：
文献类型：
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作者：
Jiang, Yongwen;McDonald, James V.;Alexander-Scott, Nicole
背景：在美国，吸毒过量是一个日益严重的公共卫生问题。罗德岛还面临着严重的药物过量死亡流行，按年龄调整后的药物过量死亡率在美国排名第六。目的：监测与药物过量相关的急诊科(ED)就诊、住院和死亡的趋势，并根据人口统计学、出院状况、意图和涉及的具体药物对药物过量进行分类，以规划卫生保健资源分配、精神卫生服务、药物滥用治疗、预防和政策。设计：横断面研究。地点：2005-2014年急诊科、出院、本研究使用的是死亡数据。主要结果衡量标准：年龄调整后的比率是通过使用特定年龄的罗德岛2010标准人口计算的。医疗保健成本和利用项目的成本与收费比率被用来将医院总费用转换为成本。结果：住院病例一般为最严重的病例，住院病例明显少于急诊科，其特点不同于急诊科就诊。超过一半的ED病例是药物过量造成的意外伤害，但超过一半的出院病例是药物过量导致的自杀/自残。通常情况下，导致入院的女性比男性多得多。在罗德岛州，2014年有249人死于药物过量。吸毒过量死亡更可能是年轻人、男性、白人和居住在郊区的人。影响：非致命性和致命性吸毒过量数据对于了解这一公共卫生流行病的范围、发生率和广度很重要，并可以指导吸毒过量干预工作。在罗德岛州，政策制定者可以使用药物过量数据来瞄准高危亚群，以减少过量服药的伤害和死亡。罗德岛的研究可以与其他州分享。结论：无论哪种药物，过量服药在罗德岛州仍然是一个公共健康危机。它是一种动态的流行病，需要公共卫生、行为卫生、公共安全、诊所、药房和社区之间的合作。实时跟踪药物过量的能力将是快速有效地应对罗德岛州不断演变的药物过量流行的重要工具。
Context: Drug overdoses are a growing public health problem in the United States. Rhode Island is also confronted with a serious epidemic of drug overdose deaths and ranks sixth worst in the United States for age-adjusted drug overdose death rate.Objective: To monitor trends of drug overdose-related emergency department (ED) visits, hospitalizations, and deaths and classify the drug overdoses by demographics, discharge status, intent, and specific drug involved to plan for health care resource allocation, mental health services, drug abuse treatment, prevention, and policies.Design: Cross-sectional study.Setting: The 2005-2014 ED, hospital discharge, and death data were used for this study.Main Outcome Measure: Age-adjusted rates were calculated by using age-specific Rhode Island 2010 standard population. Healthcare Cost and Utilization Project cost-to-charge ratios were used to convert total hospital charges to costs. The descriptive analysis was performed.Results: Hospitalizations generally represent the most severe cases; there are substantially fewer cases than are seen in the ED, and their characteristics are different from ED visits. More than half of the ED cases were an unintentional injury by drug overdose, but more than half of the hospital discharge data cases were a suicide/self-inflicted injury by drug overdose. There were typically much more females than males that result in a hospital admission. In Rhode Island, there were 249 drug overdose deaths in 2014. Drug overdose fatalities were more likely to be young, male, white, and those who reside in suburban regions.Implications: Nonfatal and fatal drug overdose data are important for understanding the scope, incidence, and breadth of this public health epidemic and can guide overdose intervention efforts. In Rhode Island, policy makers can use drug overdose data to target high-risk subpopulations to reduce overdose injuries and fatalities. The Rhode Island study can be shared with other states.Conclusions: Regardless of the type of drug, overdoses remain a public health crisis in Rhode Island. It is a dynamic epidemic and needs partnership among public health, behavioral health, public safety, clinic, pharmacy, and communities. The ability to track drug overdose in real time will be an essential tool to respond to the constantly evolving drug overdose epidemic in Rhode Island quickly and effectively.