Abstract：
OBJECTIVE: To study the proportion and predictors of outpatient physician follow-up within 60 days of substance-related emergency department (ED) visits for Ontario youth.
METHODS: We examined administrative data on substance-related ED visits before and during the COVID-19 pandemic among youths aged 10-24 years in Ontario, Canada. Substance-related visits were identified using International Classification of Diseases-10-CA codes. We described demographic characteristics, receipt of mental health services in the year before the ED visit, disposition from the ED, and follow-up services within 60 days of the ED visit.
RESULTS: Between April 1, 2017, and May 31, 2021, 64,236 youth had at least one ED visit for substance use. Visits for alcohol were the most common (49%), followed by cannabis (32.3%). ED visits for all substances were more prevalent during the pandemic than prepandemic, except visits for alcohol. The receipt of follow-up physician care for substance use was low (33.2% prepandemic) but increased during the pandemic (41.7%; adjusted odds ratio 1.34, 95% CI 1.28, 1.39) and varied between substances. Mental health service history in the year before the substance-related ED visit had the strongest association with receipt of follow-up physician care within 60 days (adjusted odds ratio 6.86, 95% CI 6.57, 7.17).
CONCLUSIONS: Youth frequently do not receive physician follow-ups within two months of the substance-related ED visit, although higher follow-up proportions were seen during the pandemic after the implementation of virtual care. Further research is required to understand why follow-up is low and to examine interventions that can increase connection to care.
METHODS: We examined administrative data on substance-related ED visits before and during the COVID-19 pandemic among youths aged 10-24 years in Ontario, Canada. Substance-related visits were identified using International Classification of Diseases-10-CA codes. We described demographic characteristics, receipt of mental health services in the year before the ED visit, disposition from the ED, and follow-up services within 60 days of the ED visit.
RESULTS: Between April 1, 2017, and May 31, 2021, 64,236 youth had at least one ED visit for substance use. Visits for alcohol were the most common (49%), followed by cannabis (32.3%). ED visits for all substances were more prevalent during the pandemic than prepandemic, except visits for alcohol. The receipt of follow-up physician care for substance use was low (33.2% prepandemic) but increased during the pandemic (41.7%; adjusted odds ratio 1.34, 95% CI 1.28, 1.39) and varied between substances. Mental health service history in the year before the substance-related ED visit had the strongest association with receipt of follow-up physician care within 60 days (adjusted odds ratio 6.86, 95% CI 6.57, 7.17).
CONCLUSIONS: Youth frequently do not receive physician follow-ups within two months of the substance-related ED visit, although higher follow-up proportions were seen during the pandemic after the implementation of virtual care. Further research is required to understand why follow-up is low and to examine interventions that can increase connection to care.
摘要：
目的：研究安大略省青年与物质相关的急诊科（ED）就诊60天内门诊医师随访的比例和预测因素。
方法：我们检查了安大略省10-24岁青少年在COVID-19大流行之前和期间与物质相关的ED就诊的行政数据，加拿大。使用国际疾病分类-10-CA代码确定与物质相关的访问。我们描述了人口统计特征，在急诊就诊前一年收到精神卫生服务，来自ED的处置，以及在ED访问后60天内的后续服务。
结果：在2017年4月1日至2021年5月31日之间，64,236名青年至少进行了一次药物使用ED访问。酒精的访问是最常见的（49％），其次是大麻(32.3%)。在大流行期间，所有物质的ED访问比流行前更为普遍，除了酒精访问。接受药物使用的随访医生护理的比例较低（33.2%），但在大流行期间有所增加（41.7%；调整后比值比1.34，95%CI1.28，1.39），并且在不同药物之间有所不同。物质相关ED访视前一年的精神卫生服务史与60天内接受随访医生护理的相关性最强(调整后比值比6.86，95%CI6.57，7.17)。
结论：青少年经常在与药物相关的ED就诊后两个月内没有接受医生随访，尽管在实施虚拟医疗后,大流行期间的随访比例更高.需要进一步的研究来了解为什么随访率很低，并检查可以增加与护理联系的干预措施。
方法：我们检查了安大略省10-24岁青少年在COVID-19大流行之前和期间与物质相关的ED就诊的行政数据，加拿大。使用国际疾病分类-10-CA代码确定与物质相关的访问。我们描述了人口统计特征，在急诊就诊前一年收到精神卫生服务，来自ED的处置，以及在ED访问后60天内的后续服务。
结果：在2017年4月1日至2021年5月31日之间，64,236名青年至少进行了一次药物使用ED访问。酒精的访问是最常见的（49％），其次是大麻(32.3%)。在大流行期间，所有物质的ED访问比流行前更为普遍，除了酒精访问。接受药物使用的随访医生护理的比例较低（33.2%），但在大流行期间有所增加（41.7%；调整后比值比1.34，95%CI1.28，1.39），并且在不同药物之间有所不同。物质相关ED访视前一年的精神卫生服务史与60天内接受随访医生护理的相关性最强(调整后比值比6.86，95%CI6.57，7.17)。
结论：青少年经常在与药物相关的ED就诊后两个月内没有接受医生随访，尽管在实施虚拟医疗后,大流行期间的随访比例更高.需要进一步的研究来了解为什么随访率很低，并检查可以增加与护理联系的干预措施。
