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Emergency Department Use among Patients with Mental Health Problems: Profiles, Correlates, and Outcomes

Author

Listed:
  • Marie-Josée Fleury

    (Department of Psychiatry, McGill University, 1033, Pine Avenue West, Montreal, QC H3A 1A1, Canada
    Douglas Hospital Research Centre, Douglas Mental Health University Institute, 6875 LaSalle Blvd., Montreal, QC H4H 1R3, Canada)

  • Zhirong Cao

    (Douglas Hospital Research Centre, Douglas Mental Health University Institute, 6875 LaSalle Blvd., Montreal, QC H4H 1R3, Canada)

  • Guy Grenier

    (Douglas Hospital Research Centre, Douglas Mental Health University Institute, 6875 LaSalle Blvd., Montreal, QC H4H 1R3, Canada)

Abstract

Patients with mental health (MH) problems are known to use emergency departments (EDs) frequently. This study identified profiles of ED users and associated these profiles with patient characteristics and outpatient service use, and with subsequent adverse outcomes. A 5-year cohort of 11,682 ED users was investigated (2012–2017), using Quebec (Canada) administrative databases. ED user profiles were identified through latent class analysis, and multinomial logistic regression used to associate patients’ characteristics and their outpatient service use. Cox regressions were conducted to assess adverse outcomes 12 months after the last ED use. Four ED user profiles were identified: “Patients mostly using EDs for accessing MH services” (Profile 1, incident MDs); “Repeat ED users” (Profile 2); “High ED users” (Profile 3); “Very high and recurrent high ED users” (Profile 4). Profile 4 and 3 patients exhibited the highest ED use along with severe conditions yet received the most outpatient care. The risk of hospitalization and death was higher in these profiles. Their frequent ED use and adverse outcomes might stem from unmet needs and suboptimal care. Assertive community treatments and intensive case management could be recommended for Profiles 4 and 3, and more extensive team-based GP care for Profiles 2 and 1.

Suggested Citation

  • Marie-Josée Fleury & Zhirong Cao & Guy Grenier, 2024. "Emergency Department Use among Patients with Mental Health Problems: Profiles, Correlates, and Outcomes," IJERPH, MDPI, vol. 21(7), pages 1-18, June.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:7:p:864-:d:1426604
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    References listed on IDEAS

    as
    1. Lia Gentil & Guy Grenier & Helen-Maria Vasiliadis & Christophe Huỳnh & Marie-Josée Fleury, 2021. "Predictors of Recurrent High Emergency Department Use among Patients with Mental Disorders," IJERPH, MDPI, vol. 18(9), pages 1-17, April.
    2. Gilles Celeux & Gilda Soromenho, 1996. "An entropy criterion for assessing the number of clusters in a mixture model," Journal of Classification, Springer;The Classification Society, vol. 13(2), pages 195-212, September.
    3. Lia Gentil & Guy Grenier & Helen-Maria Vasiliadis & Marie-Josée Fleury, 2022. "Predictors of Length of Hospitalization and Impact on Early Readmission for Mental Disorders," IJERPH, MDPI, vol. 19(22), pages 1-19, November.
    4. Wang, P.S. & Demler, O. & Kessler, R.C., 2002. "Adequacy of treatment for serious mental illness in the United States," American Journal of Public Health, American Public Health Association, vol. 92(1), pages 92-98.
    5. Lampros Samartzis & Michael A. Talias, 2019. "Assessing and Improving the Quality in Mental Health Services," IJERPH, MDPI, vol. 17(1), pages 1-31, December.
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