Utilization of the emergency department after self‐inflicted injury

Colman, Ian; Dryden, Donna M; Thompson, Aiko K.; Chahal, Anthony M.; Borden, Kim; Rowe, Brian H.; Voaklander, Donald C.

doi:10.1111/j.1553-2712.2004.tb01423.x

Cited by 51 publications

(38 citation statements)

References 36 publications

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“…Previous studies using these ACCS data have shown that diagnostic accuracy is approximately 97%. [36][37][38] Also abstracted were grouped, institutional data (rural-based vs. urban-based institutions, pediatric vs. general EDs). Urban areas met the Statistics Canada definition of census metropolitan area or census agglomeration, namely, an urban core population of more than 10,000 including all neighboring municipalities where at least half of the labor force commutes to the urban core.…”

Section: Study Protocolmentioning

confidence: 99%

Who Comes Back? Characteristics and Predictors of Return to Emergency Department Services for Pediatric Mental Health Care

Newton

Ali²,

Johnson³

et al. 2010

Academic Emergency Medicine

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Objectives: The objective of this study was to investigate predictors of emergency department (ED) return visits for pediatric mental health care. The authors hypothesized that through the identification of clinical and health system variables that predict return ED visits, which children and adolescents would benefit from targeted interventions for persistent mental health needs could be determined.Methods: Data on 16,154 presentations by 12,589 pediatric patients (£17 years old) were examined from 2002 to 2006, using the Ambulatory Care Classification System (ACCS), a provincewide database for Alberta, Canada. Multivariable logistic regressions identified predictors, while survival analyses estimated time to ED return. Results:In the multivariable analysis, there were four patient factors significantly associated with ED return. Male sex (odds ratio [OR] = 0.78; 99% confidence interval [CI] = 0.69 to 0.89) was associated with a lower rate of return, as was child age. The likelihood of ED return increased with age. Children £5 years (OR = 0.26; 99% CI = 0.14 to 0.46) and between ages 6 and 12 (OR = 0.64; 99% CI = 0.51 to 0.79) were less likely to return, compared to 13-to 17-year-olds. Patients with families receiving full assistance for covering government health care premiums were more likely to return compared to those with no assistance (OR = 1.59; 99% CI = 1.33 to 1.91). Patients were more likely to return if their initial presentation was for a mood disorder (OR = 1.72; 99% CI = 1.46 to 2.01) or psychotic-related illness (OR = 2.53; 99% CI = 1.80 to 3.56). There were two modest health care system predictors in the model. The likelihood of return decreased for patients triaged as nonurgent (OR = 0.62; 99% CI = 0.45 to 0.87) versus those triaged as urgent (level 3 acuity) and increased for patients with visits to general (vs. pediatric) EDs (OR = 1.25; 99% CI = 1.03 to 1.52). ED region (urban vs. rural) did not predict return. Within 72 hours of discharge, 6.1 and 8.7% of patients diagnosed with a mood disorder and psychotic-related illness, respectively, returned to the ED. Throughout the study period, 28.5 and 36.6% of these diagnostic populations, respectively, returned to the ED.Conclusions: Among children and adolescents who accessed the ED for mental health concerns, being female, older in age, in receipt of social assistance, and having an initial visit for a mood disorder or psychotic-related illness were associated with return for further care. How patient presentations were triaged and whether visits were made to a pediatric or general ED also affected the likelihood of return.

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Section: Study Protocolmentioning

confidence: 99%

Who Comes Back? Characteristics and Predictors of Return to Emergency Department Services for Pediatric Mental Health Care

Newton

Ali²,

Johnson³

et al. 2010

Academic Emergency Medicine

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“…First, we were limited by diagnostic reporting. Although recent studies using Ambulatory Care Classification System data indicate diagnostic accuracy, 15,16 no formal assessment of mental health diagnostic coding in ambulatory care has been conducted.…”

Section: Limitationsmentioning

confidence: 99%

Emergency health care use and follow-up among sociodemographic groups of children who visit emergency departments for mental health crises

Newton

Rosychuk

Dong

et al. 2012

CMAJ

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“…Previous studies using ACCS data indicate that the accuracy of the diagnosis is approximately 97%. [13][14][15] The difference between the start and end dates and times provided the duration of an ED service in hours for each visit. Disposition from the ED is based on the manner in which patients are separated/released from the ambulatory service facility, and includes "discharged" (returning to previous place of residence) and "admitted" (admitted to hospital in a critical care or inpatient area in a health facility).…”

Section: Variable Descriptionmentioning

confidence: 99%

A population-based study of emergency department presentations for asthma in regions of Alberta

Rosychuk

Voaklander

Klassen

et al. 2010

CJEM

Self Cite

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Objective:We describe the epidemiology of asthma presentations to emergency departments (EDs) for 3 main regions in the province of Alberta. Methods: We used a comprehensive ED database to identify ED visits in Alberta from April 1999 to March 2005. We linked the visits to other provincial administrative databases to obtain all data on follow-up encounters for asthma during that period. Information extracted included demographics, regions of residence (Edmonton, Calgary or non-major urban [NMU]), timing of ED visits, and subsequent visits to non-ED settings. Data analysis included descriptive summaries and directly standardized visit rates. Results: During the 6-year study period, 93 146 patients made 199 991 ED visits for asthma. Crude rates in 2004/05 were 7.9/1000, 6.5/1000 and 15.4/1000 in the Edmonton, Calgary and NMU regions, respectively. The Edmonton and Calgary re gions had consistently lower visit rates than the NMU regions. The ED visits were followed by low rates of follow-up visits in a variety of non-ED settings, at different intervals. Conclusion: Asthma is a relatively common presenting problem in Alberta EDs. This study identified relatively stable rates of presentation during the study period, and variation among regions in terms of age and sex. This study provides further understanding of the variation associated with ED presentation and indicates possible targets for specific interventions to reduce asthma-related ED visits.

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Utilization of the emergency department after self‐inflicted injury

Cited by 51 publications

References 36 publications

Who Comes Back? Characteristics and Predictors of Return to Emergency Department Services for Pediatric Mental Health Care

Who Comes Back? Characteristics and Predictors of Return to Emergency Department Services for Pediatric Mental Health Care

Emergency health care use and follow-up among sociodemographic groups of children who visit emergency departments for mental health crises

A population-based study of emergency department presentations for asthma in regions of Alberta

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