Impact of Rural Dwelling on Emergency Department Visits for Individuals with Psychotic Disorders in Newfoundland and Labrador, Canada
Bibliographic record
Abstract
BACKGROUND AND HYPOTHESIS: Despite recognition that utilization of emergency departments (EDs) by youth with psychotic disorders is an area of concern, little research has been conducted investigating ED utilization in rural areas. This study tests the hypothesis: Is rural dwelling associated with increased utilization of EDs in youth with a psychotic disorder living in Newfoundland and Labrador (NL)? STUDY DESIGN: Administrative databases were utilized for a retrospective cohort study. Patients diagnosed with a psychotic disorder between April 1, 2011, and March 31, 2022, between 15 and 24 years old, and who visited an ED at least once were included. Mean monthly visits measured ED utilization. Independent variables in the analyses consisted of age, sex, geographic region, and urban or rural residence. Linear regression modeling identified significant variables associated with mean monthly ED visits in the univariate and multivariate analyses. STUDY RESULTS: Multivariate analysis indicated rural residence was significantly associated with an increased mean monthly number of ED visits compared to urban residence (B-Coefficient = 0.19, P < .01). Female sex was also significantly associated with increased mean monthly ED visits over male sex (B-Coefficient = 0.13, P < .01). CONCLUSIONS: This study identified rural residence as a factor that significantly increases the utilization of EDs by youth with psychotic disorders living in NL. However, further research is required to develop strategies to remove barriers to care and facilitate access for this population. This will be both financially beneficial for the healthcare system overall while also helping ensure the well-being of some of the most vulnerable people in our society.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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 source (direct Gemma or distilled Codex), 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".