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Sex-based differences in timely emergency department evaluations for patients with drug poisoning.
Lopez, R; Snair, M; Arrigain, S; Schold, J D; Hustey, F; Walker, L E; Phelan, M P.
Afiliação
  • Lopez R; Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: lopezr@ccf.org.
  • Snair M; Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Arrigain S; Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Schold JD; Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Hustey F; Center for Emergency Medicine, Emergency Services Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Walker LE; Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA.
  • Phelan MP; Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Center for Emergency Medicine, Emergency Services Institute, Cleveland Clinic, Cleveland, OH, USA.
Public Health ; 199: 57-64, 2021 Oct.
Article em En | MEDLINE | ID: mdl-34560476
ABSTRACT

OBJECTIVES:

Unintentional poisoning was the leading cause of injury-related death in the United States in 2017. Prescribed and illicit drugs are the most common cause of poisoning, and timely management in the emergency department (ED) is important. Our aim was to identify any disparities in wait times associated with sex for drug poisoning-related ED visits. STUDY

DESIGN:

We examined ED visits using data from the 2009-2017 National Hospital Ambulatory Medical Care Survey (NHAMCS).

METHODS:

Drug poisoning-related visits were identified using the International Classification of Diseases, Ninth or Tenth Revision, Clinical Modification codes. Delayed assessment was defined as wait times exceeding the recommended triage time. Weighted logistic regression was used.

RESULTS:

The average age was 36 years (standard error = 1.1), 54% female, 87% White and 29% had delayed assessment. Most common drugs were psychotropics (45%) and opioids (32%). Adjusting for race, payment source, urgency, multiple drug types and NSAIDs, females who had poisoning by substances other than opioids had 2.1 times higher likelihood of having a delayed assessment compared with males (odds ratio [95% confidence interval] 2.1 [1.03-4.2]), although there was no difference between sexes among visits with opioid poisoning (P = 0.27). Neither race (P = 0.23) nor payment source (P = 0.22) were associated with delayed assessment, and the sex association was consistent across these groups.

CONCLUSIONS:

Females with non-opioid drug poisoning were more likely to have delayed assessment than men. None of the other demographic factors demonstrated a correlation. Identifying more populations vulnerable to delays in the ED can help guide the development of interventions and policies to expedite care and attenuate existing disparities.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Preparações Farmacêuticas / Serviço Hospitalar de Emergência Tipo de estudo: Prognostic_studies / Qualitative_research Limite: Adult / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Preparações Farmacêuticas / Serviço Hospitalar de Emergência Tipo de estudo: Prognostic_studies / Qualitative_research Limite: Adult / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Ano de publicação: 2021 Tipo de documento: Article