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    Emergency department based intervention with adolescent substance users: 10 year economic and health outcomes

    241890_241890.pdf (851.3Kb)
    Access Status
    Open access
    Authors
    Tait, Robert
    Teoh, L.
    Kelty, E.
    Geelhoed, E.
    Mountain, D.
    Hulse, G.
    Date
    2016
    Type
    Journal Article
    
    Metadata
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    Citation
    Tait, R. and Teoh, L. and Kelty, E. and Geelhoed, E. and Mountain, D. and Hulse, G. 2016. Emergency department based intervention with adolescent substance users: 10 year economic and health outcomes. Drug and Alcohol Dependence. 165: pp. 168-174.
    Source Title
    Drug and Alcohol Dependence
    DOI
    10.1016/j.drugalcdep.2016.06.005
    School
    National Drug Research Institute (NDRI)
    URI
    http://hdl.handle.net/20.500.11937/15359
    Collection
    • Curtin Research Publications
    Abstract

    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.

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