Impact of migration from an illicit drug scene on hospital outcomes among people who use illicit drugs in Vancouver, Canada.
Impact of migration from an illicit drug scene on hospital outcomes among people who use illicit drugs in Vancouver, Canada.
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DOI：
10.1111/dar.13095
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发表时间：
2020-11
影响因子：
3.8
通讯作者：
Ti L
中科院分区：
文献类型：
--
作者：
Beaulieu T;Hayashi K;Dong H;DeBeck K;Day A;McKendry R;Kaur G;Barrios R;Milloy MJ;Ti L
使用非法药物(PWUD)的人容易受到一系列负面健康后果的影响，以及医院服务利用率的增加。残障人士也是流动人口，这对提供最佳保健服务构成了挑战。这项研究的目的是确定温哥华市中心东区(DTES)的外迁模式，该社区是PWUD服务集中的社区，并估计这些模式对PWUD住院事件的影响。数据是通过温哥华PWUD的三个前瞻性队列收集的，这些队列与卫生管理数据相关联。潜伏性班级增长分析用于确定迁移轨迹组。泊松回归被用来估计移民模式对住院事件的影响。共有1180名参与者参与了这项研究。有4个潜在类别：早期迁出(243例，20.6%)、频繁再访(112例，9.5%)、晚期迁出(219例，18.6%)、长期居住(606例，51.4%)。与那些一直住在DTES中的人相比，早期迁出组的参与者的住院事件较低(调整后的比率比=0.65；95%可信区间：0.48-0.90)。我们发现，与那些一直生活在DTES中的人相比，较早迁出DTES的PWUD患者的住院事件较少，这可能是这一轨迹组中成瘾严重程度较低的一种功能。这些发现强调了为其他轨迹群体提供过渡性健康和社会服务支持的必要性，以努力将因可预防原因而住院的人数降至最低。
People who use illicit drugs (PWUD) are vulnerable to an array of negative health outcomes, and increased hospital services utilisation. PWUD are also a transient population which poses challenges to the provision of optimal health care. The objective of this study was to identify out-migration patterns from Vancouver’s Downtown Eastside (DTES), a neighbourhood where services for PWUD are concentrated, and to estimate the impact of these patterns on hospitalisation events among PWUD. Data were collected through three prospective cohorts of PWUD in Vancouver, which were linked with health administrative data. Latent class growth analysis was used to define migration trajectory groups. Poisson regression was used to estimate the effect of migration patterns on hospitalisation events. A total of 1180 participants were included in the study. Four latent classes were identified: early migration out (243, 20.6%); frequent revisit (112, 9.5%); late migration out (219, 18.6%); and consistently living in the DTES (606, 51.4%). Compared with those who consistently lived in the DTES, participants in the early migration out group had lower hospitalisation events (adjusted rate ratio = 0.65; 95% confidence interval: 0.48–0.90). We found that PWUD who migrated out of the DTES early had lower hospitalisation events compared to those who consistently lived in the DTES, which may be a function of lesser addiction severity among this trajectory group. These findings underscore a need to provide transitional health and social service supports for other trajectory groups in an effort to minimise hospitalisation for preventable causes.
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