Acute care utilization and its associated determinants among patients with substance-related disorders: A worldwide systematic review and meta-analysis

J Psychiatr Ment Health Nurs. 2023 May 21. doi: 10.1111/jpm.12936. Online ahead of print.


Introduction: Identifying determinants of emergency department (ED) use and hospitalization among patients with substance-related disorders (SRDs) can improve health services to address unmet health needs.

Aim: The present study aimed to identify the prevalence rates of ED use and hospitalization, and their associated determinants among patients with SRDs.

Methods: Studies in English published from January 1, 1995, to December 1, 2022, were searched on PubMed, Scopus, Cochrane Library, and Web of Science to identify primary studies.

Results: The pooled prevalence rates of ED use and hospitalization among patients with SRDs were 36% and 41%, respectively. Patients with SRDs who were the most at risk of being both ED users and hospitalized were those (i) having medical insurance, (ii) having other drug and alcohol use disorders, (iii) having mental health disorders, and (iv) having chronic physical illnesses. A lower level of education increased the risk of ED use only.

Discussion: To decrease ED use and hospitalization, more comprehensive services may be offered to these vulnerable patients with diversified needs.

Implications for practice: Chronic care integrating outreach interventions could be more provided for patients with SRDs after discharge from acute care units or hospitals.

Keywords: emergency department; hospitalization; mental health disorders; substance-related disorders.

Publication types

  • Review