Determinants of emergency department use and hospitalization among people who inject drugs: A systematic review and meta-analysis

ABSTRACT

Background

The present study aimed to identify sociodemographic characteristics, risky behaviors, type of drug use, and service use variables associated with emergency department (ED) use and hospitalization among people who inject drugs (PWID).

Methods

Studies in English published from January 1, 1995, to December 15, 2021, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on ED use and hospitalization among PWID.

Results

After a detailed assessment of 17,348 outputs, a total of 19 studies met the eligibility criteria for inclusion in the analysis. Greater risks of ED use and hospitalization among PWID were associated with (i) a history of homelessness, (ii) HIV-positive status, and (iii) injecting drugs more than four times per day. Individuals were more likely to use the ED if they (i) had a history of physical abuse, (ii) were using cocaine and methamphetamine, and (iii) had used primary care services. Women and individuals with chronic physical illnesses were more likely to be hospitalized.

Conclusions

The present study is the first to integrate determinants related to ED use and hospitalization based on sociodemographic characteristics, risky behaviors, type of drug, and service use determinants among PWID. To reduce ED use and hospitalization among PWID, the paper also recommends various strategies could be implemented.

KEYWORDS:

• Emergency department use
• hospitalization
• people who inject drugs
• psychoactive substances
• primary care services

Disclosure statement

No potential conflict of interest was reported by the author(s).

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Author contributions

BA conceived the study. BA collected all the data. RM and BA analyzed and interpreted the data. BA, EA, and AB drafted the manuscript. BA, MDG, and MJF contributed to the revised paper and were responsible for all final editing. All authors commented on the drafts of the manuscript and approved the final copy of the paper for submission.

Supplementary data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14659891.2023.2202767.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.