Clinical Characterization of Methamphetamine-related Emergency Department Use in a Canadian Psychiatric Hospital
Bibliographic record
Abstract
ABSTRACT Objectives: Globally, methamphetamine (MA)-related emergency deparment (ED) visits and hospital admissions have increased. This study examined the characteristics of persons with MA-related ED encounters in a Canadian psychiatric hospital. Methods: A retrospective chart review of ED medical records was conducted between January 2019 and December 2019. Sample characteristics were described using all available 2019 data. Logistic regressions were used to examine predictors of ED visits and hospital admissions. Results: In 2019, there were 659 MA-related ED encounters, of which 438 were unique (single visits=75.6%; admissions=40.9%). Persons were, on average, 34 years old, predominantly male, and homeless. The sample was ethnically diverse, with the largest group identifying as White (58.1%). Psychotic and substance use disorders were common. Younger age and being homeless significantly predicted repeat visits, whereas female gender, non-White ethnicity, psychotic disorder diagnosis, and greater clinical acuity predicted admission. Conclusions: Our findings highlight the multiple intersecting clinical and social dimensions that are associated with more frequent MA-related ED visits and hospital admission. The vulnerable socioeconomic circumstances of this population suggest the need for targeted interventions that address both substance use and mental health concerns from an intersectional perspective to build better pathways to community care. Objectifs: Dans l’ensemble, les visites aux services d’urgence (SU) et les admissions à l’hôpital liées à la méthamphétamine (MA) ont augmenté. Cette étude a examiné les caractéristiques des personnes ayant eu des visites aux SU liées à la MA dans un hôpital psychiatrique canadien. Méthodes: Une étude rétrospective des dossiers médicaux des SU a été réalisée entre janvier 2019 et décembre 2019. Les caractéristiques de l'échantillon ont été décrites à l’aide de toutes les données disponibles de 2019. Des régressions logistiques ont été utilisées pour examiner les prédicteurs des visites aux SU et des admissions à l’hôpital. Résultats: En 2019, il y a eu 659 visites aux SU liées à la MA, dont 438 étaient uniques (visites uniques=75,6% ; admissions=40,9%). Les personnes étaient en moyenne âgées de 34 ans, principalement des hommes et des sans-abri. L'échantillon était ethniquement diversifié, mais le groupe le plus important s’identifiait comme blanc (58,1%). Les troubles psychotiques et les troubles liés à l’utilisation de substances psychoactives étaient fréquents. Le fait d’être jeune et sans-abri prédisaient de manière significative des visites répétées, tandis que le sexe féminin, l’ethnicité non blanche, le diagnostic de trouble psychotique et une plus grande acuité clinique prédisaient l’admission. Conclusions: Nos résultats mettent en évidence les multiples dimensions cliniques et sociales qui s’entrecroisent et qui sont associées à des visites plus fréquentes aux SU et à des admissions à l’hôpital liées à la MA. Les circonstances socio-économiques vulnérables de cette population suggèrent le besoin d’interventions ciblées qui abordent à la fois les problèmes de toxicomanie et de santé mentale dans une perspective intersectionnelle afin d'établir de meilleures voies vers les soins communautaires.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".