Predictors of Frequent Emergency Department Use and Hospitalization among Patients with Substance-Related Disorders Recruited in Addiction Treatment Centers

Int J Environ Res Public Health. 2022 May 28;19(11):6607. doi: 10.3390/ijerph19116607.


Few studies have assessed the overall impact of outpatient service use on acute care use, comparing patients with different types of substance-related disorders (SRD) and multimorbidity. This study aimed to identify sociodemographic and clinical characteristics and outpatient service use that predicted both frequent ED use (3+ visits/year) and hospitalization among patients with SRD. Data emanated from 14 Quebec (Canada) addiction treatment centers. Quebec administrative health databases were analyzed for a cohort of 17,819 patients over a 7-year period. Multivariable logistic regression models were produced. Patients with polysubstance-related disorders, co-occurring SRD-mental disorders, severe chronic physical illnesses, and suicidal behaviors were at highest risk of both frequent ED use and hospitalization. Having a history of homelessness, residing in rural areas, and using more outpatient services also increased the risk of acute care use, whereas high continuity of physician care protected against acute care use. Serious health problems were the main predictor for increased risk of both frequent ED use and hospitalization among patients with SRD, whereas high continuity of care was a protective factor. Improved quality of care, motivational, outreach and crisis interventions, and more integrated and collaborative care are suggested for reducing acute care use.

Keywords: addiction treatment centers; frequent emergency department use; hospitalization; patient sociodemographic and clinical characteristics; patterns of service use; substance-related disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ambulatory Care
  • Chronic Disease
  • Emergency Service, Hospital*
  • Hospitalization
  • Humans
  • Substance-Related Disorders* / epidemiology
  • Substance-Related Disorders* / therapy

Grant support

This study was funded by the Substance Use and Addiction Program of Health Canada and the Québec Ministère de la santé et des services sociaux (Ministry of Health and Social Services), grant numbers 8400886 and 8400993.