• Ann Emerg Med · Dec 2023

    Emergency Department Bridge Model and Health Services Use Among Patients With Opioid Use Disorder.

    • Mirsada Serdarevic, Matthew Cvitanovich, Brooke R MacDonald, James d'Etienne, Dustin DeMoss, and Rohit P Ojha.
    • Center for Epidemiology and Healthcare Delivery Research, JPS Health Network, Fort Worth, TX. Electronic address: mserdare@jpshealth.org.
    • Ann Emerg Med. 2023 Dec 1; 82 (6): 694704694-704.

    Study ObjectivesLittle is known about the effectiveness of bridge clinics as transitional care programs for people with opioid use disorder in emergency departments (EDs). We assessed the effect of bridge clinic referral on health services use among patients with opioid use disorder identified in the ED.MethodsWe used data for individuals aged 18 years and over with active opioid use disorder and no history of medication for opioid use disorder who were administered medication for opioid use disorder while in the ED between January 2013 and August 2022. Bridge clinic referrals started in January 2021. Eligible patients after this date comprised the intervention group. The usual care group included eligible patients before bridge clinic implementation, who were a 1:1 propensity score matched to intervention patients. We estimated risk differences and 95% confidence limits for linkage to long-term care, ED use, and inpatient admission within 120 days of the index ED visit.ResultsOur study population comprised 928 observations after matching. Patients referred to the bridge clinic had a higher risk of linkage to long-term care (risk differences=25%; 95% confidence limits: 20%, 30%), higher risk of ED use (risk differences=7.5%, 95% confidence limits: 1.6%, 13%), and lower risk of inpatient admission (risk differences= -1.9%, 95% confidence limits: -5.9%, 2.1%). Inpatient admission increased among patients with serious mental illness but decreased among patients without serious mental illness.ConclusionOur overall results suggest that bridge clinic referral increases linkage to long-term care. Nevertheless, qualitatively different effects on inpatient admission between patients with and without serious mental illness warrant consideration of unmet needs among patients with serious mental illness.Copyright © 2023 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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