ED were African-American. 98 (77.2%) SMD patients who did not use the ED were also African-American. Of the patients who visited the ED within one year of their 2014-2015 SMD encounter, 19 (10.6%) had stable living conditions, 66 (36.9%) had unstable living conditions, and 22 (12.3%) lived outside. Of the patients who did not visit the ED, 12 (9.4%) had stable living conditions, 32 (25.2%) were unstably housed, and 12 (9.4%) lived outside. The "unsure" denotation indicates the patient did not specifically disclose their living arrangements.Conclusions: Based on observations of the SMD population, the subset of the homeless who use EDs are more likely to have unstable housing situations, and are more likely to use street drugs. These findings are consistent with previous studies of high ED utilizers, and suggest that only a comprehensive approach, addressing social, physical, and mental health needs of this population will be effective in reducing unnecessary ED use and health care costs.
Introduction: Toxicologic exposures (TE) are a major preventable public health issue, with most cases due to unintentional causes. Although these cases are well documented and reported via the National Poison Data System, there is little information regarding toxicologic exposure cases in the emergency department (ED). The aim of this study was to identify demographic groups at risk for potential poisoning.
Methods: This was a cross-sectional study. We used data from the California State Emergency Department Database (SEDD) 2011 for statistical analysis.
Results: The study included 10,124,598 ED visits in California in 2011. The prevalence of TE was 383.4 (379.6-387.3) per 100,000 visits. Toxicologic exposures were most common among patients aged <10 years (555.4, 95% confidence interval [CI]: 544.5-566.5 per 100,000 visits). Overall, TE was more common among males. White patients showed the highest prevalence of TE compared to other racial groups (P <0.001). Subpopulation analysis showed Native American female patients ages 10-19 had a noticeably higher prevalence of TE (1,464.4, 95% CI: 802.9-2444.9 per 100,000). The prevalence of TE was higher in households of higher median income (P <0.001). Prevalence of TE among those with a history of substance use was also elevated.
Conclusion: Toxicologic exposure cases in the ED are elevated in particular age and race/ethnicity groups, as well as among those with a diagnosis of substance use disorder. The strength of association between these factors and TE in the general population may be different because we examined ED visits only. Further preventive and education strategies are necessary and should target the demographic groups identified in this epidemiological study.
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