scholarly journals Resident loneliness, social isolation and unplanned emergency department visits from supportive living facilities: a population-based study in Alberta, Canada

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Stephanie A. Chamberlain ◽  
Susan E. Bronskill ◽  
Zoe Hsu ◽  
Erik Youngson ◽  
Andrea Gruneir
Keyword(s):  
Emergency Department ◽  
Health Service ◽  
Social Isolation ◽  
Service Use ◽  
Population Based ◽  
Emergency Department Visits ◽  
Health Service Use ◽  
Care Providers ◽  
Ed Visits ◽  
Socially Isolated

Abstract Background Supportive living (SL) facilities are intended to provide a residential care setting in a less restrictive and more cost-effective way than nursing homes (NH). SL residents with poor social relationships may be at risk for increased health service use. We describe the demographic and health service use patterns of lonely and socially isolated SL residents and to quantify associations between loneliness and social isolation on unplanned emergency department (ED) visits. Methods We conducted a retrospective cohort study using population-based linked health administrative data from Alberta, Canada. All SL residents aged 18 to 105 years who had at least one Resident Assessment Instrument-Home Care (RAI-HC) assessment between April 1, 2013 and March 31, 2018 were observed. Loneliness and social isolation were measured as a resident indicating that he/she feels lonely and if the resident had neither a primary nor secondary caregiver, respectively. Health service use in the 1 year following assessment included unplanned ED visits, hospital admissions, admission to higher levels of SL, admission to NH and death. Multivariable Cox proportional hazard models examined the association between loneliness and social isolation on the time to first unplanned ED visit. Results We identified 18,191 individuals living in Alberta SL facilities. The prevalence of loneliness was 18% (n = 3238), social isolation was 4% (n = 713). Lonely residents had the greatest overall health service use. Risk of unplanned ED visit increased with loneliness (aHR = 1.10, 95% CI: 1.04–1.15) but did not increase with social isolation (aHR = 0.95, 95% CI: 0.84–1.06). Conclusions Lonely residents had a different demographic profile (older, female, cognitively impaired) from socially isolated residents and were more likely to experience an unplanned ED visit. Our findings suggest the need to develop interventions to assist SL care providers with how to identify and address social factors to reduce risk of unplanned ED visits.

scholarly journals Acute mental health service use is increased in rheumatoid arthritis and ankylosing spondylitis: a population-based cohort study

2020 ◽  
Vol 12 ◽  
pp. 1759720X2092171
Author(s):  
Bindee Kuriya ◽  
Vivian Tia ◽  
Jin Luo ◽  
Jessica Widdifield ◽  
Simone Vigod ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Mental Health ◽  
Ankylosing Spondylitis ◽  
Health Service ◽  
Service Use ◽  
Population Based ◽  
System Level ◽  
Health Service Use ◽  
Increased Risk ◽  
Ed Visits

Background: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are associated with mental illness. Whether acute mental health (MH) service utilization (i.e. emergency visits or hospitalizations) is increased in RA or AS is not known. Methods: Two population-based cohorts were created where individuals with RA ( n = 53,240) or AS ( n = 13,964) were each matched by age, sex, and year to unaffected comparators (2002–2016). Incidence rates per 1000 person-years (PY) were calculated for a first MH emergency department (ED) presentation or MH hospitalization. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated, adjusting for demographic, clinical, and health service use variables. Results: Individuals with RA had higher rates of ED visits [6.59/1000 person-years (PY) versus 4.39/1000 PY in comparators] and hospitalizations for MH (3.11/1000 PY versus 1.80/1000 PY in comparators). Higher rates of ED visits (7.92/1000 PY versus 5.62/1000 PY in comparators) and hospitalizations (3.03/1000 PY versus 1.94/1000 PY in comparators) were also observed in AS. Overall, RA was associated with a 34% increased risk for MH hospitalization (HR 1.34, 95% CI 1.22–1.47) and AS was associated with a 36% increased risk of hospitalization (HR 1.36, 95% CI 1.12–1.63). The risk of ED presentation was attenuated, but remained significant, after adjustment in both RA (HR 1.08, 95% CI 1.01–1.15) and AS (HR 1.14, 95% CI 1.02–1.28). Conclusions: RA and AS are both independently associated with a higher rate and risk of acute ED presentations and hospitalizations for mental health conditions. These findings underscore the need for routine evaluation of MH as part of the management of chronic inflammatory arthritis. Additional research is needed to identify the underlying individual characteristics, as well as system-level variation, which may explain these differences, and to help plan interventions to make MH service use more responsive to the needs of individuals living with RA and AS.

scholarly journals Emergency department visits for self-harm in adolescents after release of the Netflix series ‘13 Reasons Why’

2021 ◽  
pp. 000486742110659
Author(s):  
Mark Sinyor ◽  
Emilie Mallia ◽  
Claire de Oliveira ◽  
Ayal Schaffer ◽  
Thomas Niederkrotenthaler ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Service ◽  
Standard Error ◽  
Service Use ◽  
Moving Average ◽  
Control Period ◽  
Emergency Department Visits ◽  
Health Service Use ◽  
Autoregressive Integrated Moving Average ◽  
Self Harm

Objective: To determine whether the release of the first season of the Netflix series ‘13 Reasons Why’ was associated with changes in emergency department presentations for self-harm. Methods: Healthcare utilization databases were used to identify emergency department and outpatient presentations according to age and sex for residents of Ontario, Canada. Data from 2007 to 2018 were used in autoregressive integrated moving average models for time series forecasting with a pre-specified hypothesis that rates of emergency department presentations for self-harm would increase in the 3-month period following the release of 13 Reasons Why (1 April 2017 to 30 June 2017). Chi-square and t tests were used to identify demographic and health service use differences between those presenting to emergency department with self-harm during this epoch compared to a control period (1 April 2016 to 30 June 2016). Results: There was a significant estimated excess of 75 self-harm-related emergency department visits (+6.4%) in the 3 months after 13 Reasons Why above what was predicted by the autoregressive integrated moving average model (standard error = 32.4; p = 0.02); adolescents aged 10–19 years had 60 excess visits (standard error = 30.7; p = 0.048), whereas adults demonstrated no significant change. Sex-stratified analyses demonstrated that these findings were largely driven by significant increases in females. There were no differences in demographic or health service use characteristics between those who presented to emergency department with self-harm in April to June 2017 vs April to June 2016. Conclusions: This study demonstrated a significant increase in self-harm emergency department visits associated with the release of 13 Reasons Why. It adds to previously published mortality, survey and helpline data collectively demonstrating negative mental health outcomes associated with 13 Reasons Why.

scholarly journals Exploring Lack of Trust in Care Providers and the Government as a Barrier to Health Service Use

2006 ◽  
Vol 96 (4) ◽  
pp. 716-721 ◽  
Author(s):  
Kathryn Whetten ◽  
Jane Leserman ◽  
Rachel Whetten ◽  
Jan Ostermann ◽  
Nathan Thielman ◽  
...  
Keyword(s):  
Health Service ◽  
Service Use ◽  
Health Service Use ◽  
Care Providers ◽  
The Government

scholarly journals Mental Health Service Use Among Children and Youth in Ontario: Population-Based Trends Over Time

2016 ◽  
Vol 61 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Sima Gandhi ◽  
Maria Chiu ◽  
Kelvin Lam ◽  
John C. Cairney ◽  
Astrid Guttmann ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Service Use ◽  
Population Based ◽  
Children And Youth ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Trends Over Time ◽  
Over Time

scholarly journals Using the Past to Predict the Future: Latent Class Analysis of Patterns of Health Service Use of Older Adults in the Emergency Department

2014 ◽  
Vol 62 (4) ◽  
pp. 711-715 ◽  
Author(s):  
S. Nicole Hastings ◽  
Heather E. Whitson ◽  
Richard Sloane ◽  
Lawrence R. Landerman ◽  
Carolyn Horney ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Health Service ◽  
Latent Class Analysis ◽  
Service Use ◽  
Latent Class ◽  
Health Service Use ◽  
Class Analysis ◽  
The Past ◽  
The Future

scholarly journals The impact of COVID-19 on hospital admissions and emergency department visits: A population-based study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252441
Author(s):  
Elissa Rennert-May ◽  
Jenine Leal ◽  
Nguyen Xuan Thanh ◽  
Eddy Lang ◽  
Shawn Dowling ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
Hospital Admissions ◽  
Population Based ◽  
Emergency Department Visits ◽  
System Capacity ◽  
Population Based Study ◽  
Health Measures ◽  
Ed Visits ◽  
The Impact

Background As a result of the novel coronavirus disease 2019 (COVID-19), there have been widespread changes in healthcare access. We conducted a retrospective population-based study in Alberta, Canada (population 4.4 million), where there have been approximately 1550 hospital admissions for COVID-19, to determine the impact of COVID-19 on hospital admissions and emergency department (ED visits), following initiation of a public health emergency act on March 15, 2020. Methods We used multivariable negative binomial regression models to compare daily numbers of medical/surgical hospital admissions via the ED between March 16-September 23, 2019 (pre COVID-19) and March 16-September 23, 2020 (post COVID-19 public health measures). We compared the most frequent diagnoses for hospital admissions pre/post COVID-19 public health measures. A similar analysis was completed for numbers of daily ED visits for any reason with a particular focus on ambulatory care sensitive conditions (ACSC). Findings There was a significant reduction in both daily medical (incident rate ratio (IRR) 0.86, p<0.001) and surgical (IRR 0.82, p<0.001) admissions through the ED in Alberta post COVID-19 public health measures. There was a significant decline in daily ED visits (IRR 0.65, p<0.001) including ACSC (IRR 0.75, p<0.001). The most common medical/surgical diagnoses for hospital admissions did not vary substantially pre and post COVID-19 public health measures, though there was a significant reduction in admissions for chronic obstructive pulmonary disease and a significant increase in admissions for mental and behavioral disorders due to use of alcohol. Conclusions Despite a relatively low volume of COVID-19 hospital admissions in Alberta, there was an extensive impact on our healthcare system with fewer admissions to hospital and ED visits. This work generates hypotheses around causes for reduced hospital admissions and ED visits which warrant further investigation. As most publicly funded health systems struggle with health-system capacity routinely, understanding how these reductions can be safely sustained will be critical.

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