Profiles of Emergency Department Users with Psychiatric Disorders Related to Barriers to Outpatient Care

Tiffany Chen, Zhirong Cao, Francine Ferland, Lambert Farand and Marie-Josée Fleury ()
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Tiffany Chen: Department of Psychiatry, McGill University, Montreal, QC H3A 1A1, Canada
Zhirong Cao: Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montreal, QC H4H 1R3, Canada
Francine Ferland: School of Social Work, Addiction Rehabilitation Centre, Laval University, National Capital University Integrated Health and Social Services Centre, Quebec City, QC G1V 0A6, Canada
Lambert Farand: Department of Health Administration, Policy, and Evaluation, School of Public Health, University of Montreal, Montreal, QC H3N 1X9, Canada
Marie-Josée Fleury: Department of Psychiatry, McGill University, Montreal, QC H3A 1A1, Canada

IJERPH, 2024, vol. 21, issue 2, 1-15

Abstract: Emergency department (ED) overcrowding is a growing problem worldwide. High ED users have been historically targeted to reduce ED overcrowding and associated high costs. Patients with psychiatric disorders, including substance-related disorders (SRDs), are among the largest contributors to high ED use. Since EDs are meant for urgent cases, they are not an appropriate setting for treating recurrent patients or replacing outpatient care. Identifying ED user profiles in terms of perceived barriers to care, service use, and sociodemographic and clinical characteristics is crucial to reduce ED use and unmet needs. Data were extracted from medical records and a survey was conducted among 299 ED patients from 2021 to 2022 in large Quebec networks. Cluster algorithms and comparison tests identified three profiles. Profile 1 had the most patients without barriers to care, with case managers, and received the best primary care. Profile 2 reported moderate barriers to care and low primary care use, best quality of life, and more serious psychiatric disorders. Profile 3 had the most barriers to care, high ED users, and lower service satisfaction and perceived mental/health conditions. Our findings and recommendations inform decision-makers on evidence-based strategies to address the unmet needs of these vulnerable populations.

Keywords: mental health; psychiatric disorders; emergency departments; health services; barriers to care; needs assessment (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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