Typologies of Individuals Attending an Addiction Rehabilitation Center Based on Diagnosis of Mental Disorders

Huỳnh, Christophe; Tremblay, Joël; Fleury, Marie‐Josée

doi:10.1016/j.jsat.2016.09.007

Cited by 15 publications

(15 citation statements)

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“…Some classes identified in our study show similarities with those of previous studies that assessed very distinct samples of people with MD-SUD. For example, one study of 4526 individuals receiving services from an addiction rehabilitation center 48 identified a class of individuals with multiple MDs and SUDs and high emergency department use that bore some resemblance to our class 2. Another study of 406 individuals who experienced at least one episode of MD 58 identified a subclass of middle-aged females with high income, depressive disorders and moderate health services that looked quite similar to our class 3.…”

Section: Discussionmentioning

confidence: 99%

“…Cluster analysis represents a reliable method for identifying subgroups of patients based on multiple variables. 44 Cluster analysis has been used to identify several types of profiles among people with MD-SUD who use diverse health services; for example, patients admitted to hospital for the first time, 45 patients who frequently use in-patient mental health services, 46 people with schizophrenia receiving health services in the community, 47 people with MD-SUD treated in addiction rehabilitation centers, 48 those receiving help from general mental health services, 49 people who use antidepressants 50 and homeless individuals with MD-SUD who use health services. 51 The present study aimed to develop a typology based on the frequency of emergency department visits for MD-SUD among a sample of 320 people in Quebec (Canada).…”

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confidence: 99%

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Typology of patients who use emergency departments for mental and substance use disorders

2020

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Background Identifying profiles of people with mental and substance use disorders who use emergency departments may help guide the development of interventions more appropriate to their particular characteristics and needs. Aims To develop a typology for the frequency of visits to the emergency department for mental health reasons based on the Andersen model. Method Questionnaires were completed by patients who attended an emergency department (n = 320), recruited in Quebec (Canada), and administrative data were obtained related to sociodemographic/socioeconomic characteristics, mental health diagnoses including alcohol and drug use, and emergency department and mental health service utilization. A cluster analysis was performed, identifying needs, predisposing and enabling factors that differentiated subclasses of participants according to frequency of emergency department visits for mental health reasons. Results Four classes were identified. Class 1 comprised individuals with moderate emergency department use and low use of other health services; mostly young, economically disadvantaged males with substance use disorders. Class 2 comprised individuals with high emergency department and specialized health service use, with multiple mental and substance use disorders. Class 3 comprised middle-aged, economically advantaged females with common mental disorders, who made moderate use of emergency departments but consulted general practitioners. Class 4 comprised older individuals with multiple chronic physical illnesses co-occurring with mental disorders, who made moderate use of the emergency department, but mainly consulted general practitioners. Conclusions The study found heterogeneity in emergency department use for mental health reasons, as each of the four classes represented distinct needs, predisposing and enabling factors. As such, interventions should be tailored to different classes of patients who use emergency departments, based on their characteristics.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Typology of patients who use emergency departments for mental and substance use disorders

2020

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“…A reliable method for identifying categories based on groupings of different types of variables associated with subjects is cluster analysis [33]. Cluster analysis has often been used for the creation of typologies of MH service users based on their sociodemographic, clinical and service use characteristics [34][35][36][37][38]. However, to our knowledge, no previous study has used cluster analysis to identify categories that take into account particular characteristics of MH structures, MH teams and MH services users in networks.…”

Section: Research and Theorymentioning

confidence: 99%

Relationships Among Structures, Team Processes, and Outcomes for Service Users in Quebec Mental Health Service Networks

Fleury¹,

Grenier²,

Bamvita

2020

International Journal of Integrated Care

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Background: Few studies have identified and compared profiles of mental health service networks (MHSN) in terms of structures, processes, and outcomes, based on cluster analyses and perceptions of team managers, MH professionals and service users. This study assessed these associations in Quebec metropolitan, urban and semi-urban MHSN. Methods: A framework adapted from the Donabedian model guided data management, and cluster analyses were used to identify categories. Study participants included team managers (n = 45), MH professionals (n = 311) and service users (n = 327). Results: For all three MHSN, a common outcome category emerged: service users with complex MH problems and negative outcomes. The Metropolitan network reported two categories for structures (specialized MH teams, primary care MH teams) and processes (senior medical professional, psychosocial professionals), and outcomes (middle-age men with positive outcomes, older women with few MH problems). The Urban and Semi-urban networks revealed one category for structures (all teams) and service user (young service users with drug disorders), but two for processes (psychosocial professionals: urban, all professionals: semi-urban). Conclusion: The Metropolitan MHSN showed greater heterogeneity regarding structures and team processes than the other two MHSN. Service user outcomes were largely associated with clinical characteristics, regardless of network configurations for structures and team processes.

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“…These studies mostly assessed the types of services patients used, comparing in hospital settings profiles of patients with higher use of SRD, MD or other programs [ 15 , 17 ], or main SRD treatment (e.g., Alcoholics Anonymous) [ 16 ], principal clinicians consulted (e.g., psychiatrist, psychologist) [ 16 , 18 , 19 ], or outpatient versus acute care used [ 15 , 18 ]. Most studies included patients with SRD in general [ 15 , 17 , 18 ], whereas a few focused on MD-SRD [ 19 ] or alcohol-related disorders only [ 16 ]. Some studies investigated the evolution of service use profiles according to age [ 19 ] over a three- to eight-year period, leading to treatment disengagement [ 17 ] or reduced alcohol use [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…Most studies have linked patient service use profiles to their sociodemographic and clinical characteristics, with MD as the main associated clinical variable tested. Most profiles of low service users have consisted of men and younger patients [ 18 ], whereas profiles showing more GP use included more women and older patients [ 19 ]. More multiple service users had several SRD or MD [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Profiles of quality of outpatient care use, associated sociodemographic and clinical characteristics, and adverse outcomes among patients with substance-related disorders

Fleury

Cao

Grenier

et al. 2023

Subst Abuse Treat Prev Policy

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Background This study identified patient profiles in terms of their quality of outpatient care use, associated sociodemographic and clinical characteristics, and adverse outcomes based on frequent emergency department (ED) use, hospitalization, and death from medical causes. Methods A cohort of 18,215 patients with substance-related disorders (SRD) recruited in addiction treatment centers was investigated using Quebec (Canada) health administrative databases. A latent class analysis was produced, identifying three profiles of quality of outpatient care use, while multinomial and logistic regressions tested associations with patient characteristics and adverse outcomes, respectively. Results Profile 1 patients (47% of the sample), labeled “Low outpatient service users”, received low quality of care. They were mainly younger, materially and socially deprived men, some with a criminal history. They had more recent SRD, mainly polysubstance, and less mental disorders (MD) and chronic physical illnesses than other Profiles. Profile 2 patients (36%), labeled “Moderate outpatient service users”, received high continuity and intensity of care by general practitioners (GP), while the diversity and regularity in their overall quality of outpatient service was moderate. Compared with Profile 1, they were older, less likely to be unemployed or to live in semi-urban areas, and most had common MD and chronic physical illnesses. Profile 3 patients (17%), labeled “High outpatient service users”, received more intensive psychiatric care and higher quality of outpatient care than other Profiles. Most Profile 3 patients lived alone or were single parents, and fewer lived in rural areas or had a history of homelessness, versus Profile 1 patients. They were strongly affected by MD, mostly serious MD and personality disorders. Compared with Profile 1, Profile 3 had more frequent ED use and hospitalizations, followed by Profile 2. No differences in death rates emerged among the profiles. Conclusions Frequent ED use and hospitalization were strongly related to patient clinical and sociodemographic profiles, and the quality of outpatient services received to the severity of their conditions. Outreach strategies more responsive to patient needs may include motivational interventions and prevention of risky behaviors for Profile 1 patients, collaborative GP-psychiatrist care for Profile 2 patients, and GP care and intensive specialized treatment for Profile 3 patients.

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Typologies of Individuals Attending an Addiction Rehabilitation Center Based on Diagnosis of Mental Disorders

Cited by 15 publications

References 100 publications

Typology of patients who use emergency departments for mental and substance use disorders

Typology of patients who use emergency departments for mental and substance use disorders

Relationships Among Structures, Team Processes, and Outcomes for Service Users in Quebec Mental Health Service Networks

Profiles of quality of outpatient care use, associated sociodemographic and clinical characteristics, and adverse outcomes among patients with substance-related disorders

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