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Patterns of health care utilization among people who overdosed from illegal drugs: a descriptive analysis using the BC Provincial Overdose Cohort.
Health Promot Chronic Dis Prev Can. 2018 Sep; 38(9):328-333.HP

Abstract

INTRODUCTION

British Columbia (BC) declared a public health emergency in April 2016 in response to a rapid rise in overdose deaths. Further understanding of health care utilization is needed to inform prevention strategies for individuals who overdose from illegal drugs.

METHODS

The Provincial Overdose Cohort includes linked administrative data on health care utilization by individuals who experienced an illegal drug overdose event in BC between 1 January 2015 and 30 November 2016. Overdose cases were identified using data from ambulance services, coroners' investigations, poison control centre calls and hospital, emergency department and physician administrative records. In total, 10 455 overdose cases were identified and compared with 52 275 controls matched on age, sex and area of residence for a descriptive analysis of health care utilization.

RESULTS

Two-thirds (66%) of overdose cases were male and about half (49%) were 20-39 years old. Over half of the cases (54%) visited the emergency department and about one-quarter (26%) were admitted to hospital in the year before the overdose event, compared with 17% and 9% of controls, respectively. Nevertheless, nearly onefifth (19%) of cases were recorded leaving the emergency department without being seen or against medical advice. High proportions of both cases (75%) and controls (72%) visited community-based physicians. Substance use and mental health-related concerns were the most common diagnoses among people who went on to overdose.

CONCLUSION

People who overdosed frequently accessed the health care system in the year before the overdose event. In light of the high rates of health care use, there may be opportunities to identify at-risk individuals before they overdose and connect them with targeted programs and evidence-based interventions. Further work using the BC Provincial Overdose Cohort will focus on identifying risk factors for overdose events and death by overdose.

Authors+Show Affiliations

BC Centre for Disease Control, Vancouver, British Columbia, Canada. School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.BC Centre for Disease Control, Vancouver, British Columbia, Canada. School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.BC Centre for Disease Control, Vancouver, British Columbia, Canada.Fraser Health Authority, Surrey, British Columbia, Canada.Fraser Health Authority, Surrey, British Columbia, Canada.Island Health Authority, Victoria, British Columbia, Canada. BC Observatory for Population and Public Health, BC Centre for Disease Control, Vancouver, British Columbia, Canada.First Nations Health Authority, Vancouver, British Columbia, Canada. Public Health Agency of Canada, Ottawa, Ontario, Canada.BC Centre for Disease Control, Vancouver, British Columbia, Canada. Public Health Agency of Canada, Ottawa, Ontario, Canada.BC Centre for Disease Control, Vancouver, British Columbia, Canada. BC Observatory for Population and Public Health, BC Centre for Disease Control, Vancouver, British Columbia, Canada.BC Coroners Service, Burnaby, British Columbia, Canada.BC Emergency Health Services, Victoria, British Columbia, Canada.

Pub Type(s)

Journal Article

Language

eng fre

PubMed ID

30226726

Citation

Otterstatter, Michael C., et al. "Patterns of Health Care Utilization Among People Who Overdosed From Illegal Drugs: a Descriptive Analysis Using the BC Provincial Overdose Cohort." Health Promotion and Chronic Disease Prevention in Canada : Research, Policy and Practice, vol. 38, no. 9, 2018, pp. 328-333.
Otterstatter MC, Crabtree A, Dobrer S, et al. Patterns of health care utilization among people who overdosed from illegal drugs: a descriptive analysis using the BC Provincial Overdose Cohort. Health Promot Chronic Dis Prev Can. 2018;38(9):328-333.
Otterstatter, M. C., Crabtree, A., Dobrer, S., Kinniburgh, B., Klar, S., Leamon, A., May-Hadford, J., Mill, C., Park, M., Tu, A. W., & Zheng, L. (2018). Patterns of health care utilization among people who overdosed from illegal drugs: a descriptive analysis using the BC Provincial Overdose Cohort. Health Promotion and Chronic Disease Prevention in Canada : Research, Policy and Practice, 38(9), 328-333. https://doi.org/10.24095/hpcdp.38.9.04
Otterstatter MC, et al. Patterns of Health Care Utilization Among People Who Overdosed From Illegal Drugs: a Descriptive Analysis Using the BC Provincial Overdose Cohort. Health Promot Chronic Dis Prev Can. 2018;38(9):328-333. PubMed PMID: 30226726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patterns of health care utilization among people who overdosed from illegal drugs: a descriptive analysis using the BC Provincial Overdose Cohort. AU - Otterstatter,Michael C, AU - Crabtree,Alexis, AU - Dobrer,Sabina, AU - Kinniburgh,Brooke, AU - Klar,Salman, AU - Leamon,Anthony, AU - May-Hadford,Jennifer, AU - Mill,Christopher, AU - Park,Mina, AU - Tu,Andrew W, AU - Zheng,Lu, PY - 2018/9/19/entrez PY - 2018/9/19/pubmed PY - 2019/1/27/medline KW - drug overdose KW - harm reduction KW - healthcare KW - opioids KW - street drugs SP - 328 EP - 333 JF - Health promotion and chronic disease prevention in Canada : research, policy and practice JO - Health Promot Chronic Dis Prev Can VL - 38 IS - 9 N2 - INTRODUCTION: British Columbia (BC) declared a public health emergency in April 2016 in response to a rapid rise in overdose deaths. Further understanding of health care utilization is needed to inform prevention strategies for individuals who overdose from illegal drugs. METHODS: The Provincial Overdose Cohort includes linked administrative data on health care utilization by individuals who experienced an illegal drug overdose event in BC between 1 January 2015 and 30 November 2016. Overdose cases were identified using data from ambulance services, coroners' investigations, poison control centre calls and hospital, emergency department and physician administrative records. In total, 10 455 overdose cases were identified and compared with 52 275 controls matched on age, sex and area of residence for a descriptive analysis of health care utilization. RESULTS: Two-thirds (66%) of overdose cases were male and about half (49%) were 20-39 years old. Over half of the cases (54%) visited the emergency department and about one-quarter (26%) were admitted to hospital in the year before the overdose event, compared with 17% and 9% of controls, respectively. Nevertheless, nearly onefifth (19%) of cases were recorded leaving the emergency department without being seen or against medical advice. High proportions of both cases (75%) and controls (72%) visited community-based physicians. Substance use and mental health-related concerns were the most common diagnoses among people who went on to overdose. CONCLUSION: People who overdosed frequently accessed the health care system in the year before the overdose event. In light of the high rates of health care use, there may be opportunities to identify at-risk individuals before they overdose and connect them with targeted programs and evidence-based interventions. Further work using the BC Provincial Overdose Cohort will focus on identifying risk factors for overdose events and death by overdose. SN - 2368-738X UR - https://www.unboundmedicine.com/medline/citation/30226726/Patterns_of_health_care_utilization_among_people_who_overdosed_from_illegal_drugs:_a_descriptive_analysis_using_the_BC_Provincial_Overdose_Cohort_ L2 - https://doi.org/10.24095/hpcdp.38.9.04 DB - PRIME DP - Unbound Medicine ER -