Emergency department based intervention with adolescent substance users: 10 year economic and health outcomes
BACKGROUND: Alcohol and other drug (AOD) use are significant cause of disease burden and costs among adolescents. METHODS: We conducted a randomized trial in hospital emergency departments (ED) following an AOD-related presentation, comparing usual care with brief advice and referral to link adolesc...
| Main Authors: | , , , , , |
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| Format: | Journal Article |
| Published: |
Elsevier Ireland Ltd
2016
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| Online Access: | http://hdl.handle.net/20.500.11937/15359 |
| _version_ | 1848748871914618880 |
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| author | Tait, Robert Teoh, L. Kelty, E. Geelhoed, E. Mountain, D. Hulse, G. |
| author_facet | Tait, Robert Teoh, L. Kelty, E. Geelhoed, E. Mountain, D. Hulse, G. |
| author_sort | Tait, Robert |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | BACKGROUND: Alcohol and other drug (AOD) use are significant cause of disease burden and costs among adolescents. METHODS: We conducted a randomized trial in hospital emergency departments (ED) following an AOD-related presentation, comparing usual care with brief advice and referral to link adolescents aged 12-19 years with external AOD services. Subsequently, we used health data linkage to assemble data on mortality, hospital admissions, ED attendances, out-patient mental health and use of opiate pharmacotherapies in the next 10 years. From these, treatment costs and rates of events were estimated and compared using generalized linear models. RESULTS: Those who received the intervention had lower costs ($22 versus $227: z=3.16, p=0.002) and rates (0.03 versus 0.25: z=2.57, p=0.010) of ED mental health AOD presentations. However, the intervention did not significantly reduce overall mean health costs per patient (intervention $58746 versus control $64833, p=0.800). Similarly, there was no significant difference in the costs associated with hospitalizations ($48920 versus $50911 p=0.924), overall ED presentations ($4266 versus $4150, p=0.916), out-patient mental health services ($4494 versus $7717, p=0.282), or opiate pharmacotherapies ($1013 versus $2054, p=0.209). Injecting drug use was a significant baseline predictor of subsequent costs in the cohort (z=2.64, p=0.008). CONCLUSIONS: An ED delivered intervention may reduce direct ED costs and subsequent ED AOD attendances. There was also some indication that overall costs may be impacted, with economically large but non-significant differences between the groups. The high costs and morbidity incurred by some of this cohort illustrate the importance of targeting high-risk adolescents. |
| first_indexed | 2025-11-14T07:11:56Z |
| format | Journal Article |
| id | curtin-20.500.11937-15359 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T07:11:56Z |
| publishDate | 2016 |
| publisher | Elsevier Ireland Ltd |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-153592017-09-13T15:45:38Z Emergency department based intervention with adolescent substance users: 10 year economic and health outcomes Tait, Robert Teoh, L. Kelty, E. Geelhoed, E. Mountain, D. Hulse, G. BACKGROUND: Alcohol and other drug (AOD) use are significant cause of disease burden and costs among adolescents. METHODS: We conducted a randomized trial in hospital emergency departments (ED) following an AOD-related presentation, comparing usual care with brief advice and referral to link adolescents aged 12-19 years with external AOD services. Subsequently, we used health data linkage to assemble data on mortality, hospital admissions, ED attendances, out-patient mental health and use of opiate pharmacotherapies in the next 10 years. From these, treatment costs and rates of events were estimated and compared using generalized linear models. RESULTS: Those who received the intervention had lower costs ($22 versus $227: z=3.16, p=0.002) and rates (0.03 versus 0.25: z=2.57, p=0.010) of ED mental health AOD presentations. However, the intervention did not significantly reduce overall mean health costs per patient (intervention $58746 versus control $64833, p=0.800). Similarly, there was no significant difference in the costs associated with hospitalizations ($48920 versus $50911 p=0.924), overall ED presentations ($4266 versus $4150, p=0.916), out-patient mental health services ($4494 versus $7717, p=0.282), or opiate pharmacotherapies ($1013 versus $2054, p=0.209). Injecting drug use was a significant baseline predictor of subsequent costs in the cohort (z=2.64, p=0.008). CONCLUSIONS: An ED delivered intervention may reduce direct ED costs and subsequent ED AOD attendances. There was also some indication that overall costs may be impacted, with economically large but non-significant differences between the groups. The high costs and morbidity incurred by some of this cohort illustrate the importance of targeting high-risk adolescents. 2016 Journal Article http://hdl.handle.net/20.500.11937/15359 10.1016/j.drugalcdep.2016.06.005 Elsevier Ireland Ltd fulltext |
| spellingShingle | Tait, Robert Teoh, L. Kelty, E. Geelhoed, E. Mountain, D. Hulse, G. Emergency department based intervention with adolescent substance users: 10 year economic and health outcomes |
| title | Emergency department based intervention with adolescent substance users: 10 year economic and health outcomes |
| title_full | Emergency department based intervention with adolescent substance users: 10 year economic and health outcomes |
| title_fullStr | Emergency department based intervention with adolescent substance users: 10 year economic and health outcomes |
| title_full_unstemmed | Emergency department based intervention with adolescent substance users: 10 year economic and health outcomes |
| title_short | Emergency department based intervention with adolescent substance users: 10 year economic and health outcomes |
| title_sort | emergency department based intervention with adolescent substance users: 10 year economic and health outcomes |
| url | http://hdl.handle.net/20.500.11937/15359 |