RESUMO
INTRODUCTION: The purpose of this study is to compare the prevalence of hospitalization after an emergency department (ED) visit at an urban safety net hospital for youth with and without a substance use disorder. METHODS: This study used a retrospective cohort design of adolescents (aged 15-21 y; n = 14,852) treated in the ED and compared the risk of hospitalization within 90 days. RESULTS: A substance use disorder diagnosis in the ED more than doubled the risk of 90-day hospitalization (5.4% vs 2.38%; P < 0.0001). CONCLUSIONS: Compared with youth without a substance use disorder, youth with substance use disorders are likely to require additional services after an ED visit.
Assuntos
Serviço Hospitalar de Emergência , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Estudos de Coortes , Hospitalização , Humanos , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapiaRESUMO
Access to inpatient psychiatric beds remains a significant barrier to care for patients having a mental health crisis. A quality improvement initiative described here was designed to increase access to care by increasing efficiency of health care delivery on an adult and adolescent inpatient psychiatric unit. Design and implementation centered on collaborative relationships among hospital administration, physician leadership, frontline physicians, and members of the multidisciplinary treatment team. Initial 5 months of data indicated significant improvements in care access as measured by number of encounters on both units. Reductions in length of stay were made possible by optimizing internal work flows and standardizing goals of hospitalization.
