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Published Online: 31 October 2014

High Users of Emergency Departments in Quebec Among Patients With Both Schizophrenia and a Substance Use Disorder

André Ngamini-Ngui, Ph.D., Marie-Josée Fleury, Ph.D., Jocelyne Moisan, Ph.D., Jean-Pierre Grégoire, Ph.D., Alain Lesage, M.D., and Alain Vanasse, M.D., Ph.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 65, Number 11
https://doi.org/10.1176/appi.ps.201300474
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Abstract

Objective:

The study assessed factors associated over time with high use of emergency departments by patients in Quebec who had schizophrenia and a co-occurring substance use disorder.

Methods:

The cohort study included 2,921 patients who received a diagnosis of schizophrenia in 2006 and had at least one emergency department visit during fiscal year 2006–2007. Generalized estimating equations were used to estimate predictors of high use of emergency departments over time.

Results:

After adjustment for all covariates, predictors of high use over time were as follows: living in either a university medical region (OR=2.10) or a peripheral medical region (OR=2.10), frequent hospitalization (OR=1.16), and greater number of psychiatric (OR=1.64) or physical comorbidities (OR=1.23).

Conclusions:

Because high use of emergency departments is a strong indicator of poor care continuity, identified associated factors could help develop and offer new programs to be deployed in the community to better support these patients with greater needs.

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Information & Authors

Information

Published In

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Cover: Woman Sitting on Couch Looking at Picture, by Alice Barber Stephens. Library of Congress, Prints and Photographs Division, DLC/PP-1933:0012.

Psychiatric Services
Volume 65 • Number 11 • November 01, 2014
Pages: 1389 - 1391
PubMed: 25124150

History

Published ahead of print: 31 October 2014
Published online: 1 November 2014
Published in print: November 01, 2014

Authors

Details

André Ngamini-Ngui, Ph.D.
Dr. Ngamini-Ngui and Dr. Fleury are with the Centre de Réadaptation en Dépendance de Montréal, Institut Universitaire, Montreal, Quebec, Canada (e-mail: [email protected]). Dr. Ngamini-Ngui is also with the Centre de Recherche CSSS Champlain–Charles-Le Moyne, Longueuil, Quebec. Dr. Fleury is also with the Douglas Mental Health University Institute, McGill University, Montreal. Dr. Moisan and Dr. Grégoire are with the Faculté de Pharmacie, Université Laval, and with the Centre de Recherche du Centre Hospitalier Universitaire de Québec. Dr. Lesage is with the Centre de Recherche Fernand-Seguin, Hôpital Louis-H. Lafontaine, Montreal, Quebec. Dr. Vanasse is with the Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Quebec.
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Marie-Josée Fleury, Ph.D.
Dr. Ngamini-Ngui and Dr. Fleury are with the Centre de Réadaptation en Dépendance de Montréal, Institut Universitaire, Montreal, Quebec, Canada (e-mail: [email protected]). Dr. Ngamini-Ngui is also with the Centre de Recherche CSSS Champlain–Charles-Le Moyne, Longueuil, Quebec. Dr. Fleury is also with the Douglas Mental Health University Institute, McGill University, Montreal. Dr. Moisan and Dr. Grégoire are with the Faculté de Pharmacie, Université Laval, and with the Centre de Recherche du Centre Hospitalier Universitaire de Québec. Dr. Lesage is with the Centre de Recherche Fernand-Seguin, Hôpital Louis-H. Lafontaine, Montreal, Quebec. Dr. Vanasse is with the Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Quebec.
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Jocelyne Moisan, Ph.D.
Dr. Ngamini-Ngui and Dr. Fleury are with the Centre de Réadaptation en Dépendance de Montréal, Institut Universitaire, Montreal, Quebec, Canada (e-mail: [email protected]). Dr. Ngamini-Ngui is also with the Centre de Recherche CSSS Champlain–Charles-Le Moyne, Longueuil, Quebec. Dr. Fleury is also with the Douglas Mental Health University Institute, McGill University, Montreal. Dr. Moisan and Dr. Grégoire are with the Faculté de Pharmacie, Université Laval, and with the Centre de Recherche du Centre Hospitalier Universitaire de Québec. Dr. Lesage is with the Centre de Recherche Fernand-Seguin, Hôpital Louis-H. Lafontaine, Montreal, Quebec. Dr. Vanasse is with the Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Quebec.
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Jean-Pierre Grégoire, Ph.D.
Dr. Ngamini-Ngui and Dr. Fleury are with the Centre de Réadaptation en Dépendance de Montréal, Institut Universitaire, Montreal, Quebec, Canada (e-mail: [email protected]). Dr. Ngamini-Ngui is also with the Centre de Recherche CSSS Champlain–Charles-Le Moyne, Longueuil, Quebec. Dr. Fleury is also with the Douglas Mental Health University Institute, McGill University, Montreal. Dr. Moisan and Dr. Grégoire are with the Faculté de Pharmacie, Université Laval, and with the Centre de Recherche du Centre Hospitalier Universitaire de Québec. Dr. Lesage is with the Centre de Recherche Fernand-Seguin, Hôpital Louis-H. Lafontaine, Montreal, Quebec. Dr. Vanasse is with the Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Quebec.
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Alain Lesage, M.D.
Dr. Ngamini-Ngui and Dr. Fleury are with the Centre de Réadaptation en Dépendance de Montréal, Institut Universitaire, Montreal, Quebec, Canada (e-mail: [email protected]). Dr. Ngamini-Ngui is also with the Centre de Recherche CSSS Champlain–Charles-Le Moyne, Longueuil, Quebec. Dr. Fleury is also with the Douglas Mental Health University Institute, McGill University, Montreal. Dr. Moisan and Dr. Grégoire are with the Faculté de Pharmacie, Université Laval, and with the Centre de Recherche du Centre Hospitalier Universitaire de Québec. Dr. Lesage is with the Centre de Recherche Fernand-Seguin, Hôpital Louis-H. Lafontaine, Montreal, Quebec. Dr. Vanasse is with the Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Quebec.
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Alain Vanasse, M.D., Ph.D.
Dr. Ngamini-Ngui and Dr. Fleury are with the Centre de Réadaptation en Dépendance de Montréal, Institut Universitaire, Montreal, Quebec, Canada (e-mail: [email protected]). Dr. Ngamini-Ngui is also with the Centre de Recherche CSSS Champlain–Charles-Le Moyne, Longueuil, Quebec. Dr. Fleury is also with the Douglas Mental Health University Institute, McGill University, Montreal. Dr. Moisan and Dr. Grégoire are with the Faculté de Pharmacie, Université Laval, and with the Centre de Recherche du Centre Hospitalier Universitaire de Québec. Dr. Lesage is with the Centre de Recherche Fernand-Seguin, Hôpital Louis-H. Lafontaine, Montreal, Quebec. Dr. Vanasse is with the Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Quebec.
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