Impact of migration from an illicit drug scene on hospital outcomes among people who use illicit drugs in Vancouver, Canada.

Publisher: Wiley-Blackwell Country of Publication: Australia NLM ID: 9015440 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1465-3362 (Electronic) Linking ISSN: 09595236 NLM ISO Abbreviation: Drug Alcohol Rev Subsets: MEDLINE

Publication: Original Publication: Abingdon, Oxfordshire, U.K. : Carfax Pub. Co.,

Drug Users* ; Illicit Drugs* ; Substance-Related Disorders*/epidemiology; Canada/epidemiology ; Hospitalization ; Humans ; Prospective Studies

Introduction and Aims: People who use illicit drugs (PWUD) are vulnerable to an array of negative health outcomes, and increased hospital services utilisation. PWUD are also a transient population which poses challenges to the provision of optimal health care. The objective of this study was to identify out-migration patterns from Vancouver's Downtown Eastside (DTES), a neighbourhood where services for PWUD are concentrated, and to estimate the impact of these patterns on hospitalisation events among PWUD.
Design and Methods: Data were collected through three prospective cohorts of PWUD in Vancouver, which were linked with health administrative data. Latent class growth analysis was used to define migration trajectory groups. Poisson regression was used to estimate the effect of migration patterns on hospitalisation events.
Results: A total of 1180 participants were included in the study. Four latent classes were identified: early migration out (243, 20.6%); frequent revisit (112, 9.5%); late migration out (219, 18.6%); and consistently living in the DTES (606, 51.4%). Compared with those who consistently lived in the DTES, participants in the early migration out group had lower hospitalisation events (adjusted rate ratio = 0.65; 95% confidence interval: 0.48-0.90).
Discussion and Conclusion: We found that PWUD who migrated out of the DTES early had lower hospitalisation events compared to those who consistently lived in the DTES, which may be a function of lesser addiction severity among this trajectory group. These findings underscore a need to provide transitional health and social service supports for other trajectory groups in an effort to minimise hospitalisation for preventable causes.
(© 2020 Australasian Professional Society on Alcohol and other Drugs.)

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International NG Biomed Ltd; International MSFHR / St. Paul's Hospital Foundation-Providence Health Care Career Scholar Award; U01 DA038886 United States DA NIDA NIH HHS; MSH-141971 Canada CAPMC CIHR; U01 DA021525 United States DA NIDA NIH HHS; International St. Paul's Foundation; International University of British Columbia Doctoral Fellowship; International Tier 1 Canada Research Chair in Inner City Medicine; R01 DA021525 United States DA NIDA NIH HHS

Keywords: hospital outcomes; illicit drugs; migration patterns

0 (Illicit Drugs)

Date Created: 20200603 Date Completed: 20211108 Latest Revision: 20211108

20221213

PMC7864616

10.1111/dar.13095

32485075