Tara Beaulieu1,2, Kanna Hayashi1,3, Huiru Dong1,4, Kora DeBeck1,5, Andrew Day6, Rachael McKendry6, Gaganpreet Kaur1, Rolando Barrios6,7, M-J Milloy1,8, Lianping Ti1,8. 1. British Columbia Centre on Substance Use, Vancouver, Canada. 2. Graduate Programs in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada. 3. Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada. 4. School of Population and Public Health, University of British Columbia, Vancouver, Canada. 5. School of Public Policy, Simon Fraser University, Vancouver, Canada. 6. Vancouver Coastal Health, Vancouver, Canada. 7. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada. 8. Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Abstract
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.
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.
Authors: Benjamin Maas; Nadia Fairbairn; Thomas Kerr; Kathy Li; Julio S G Montaner; Evan Wood Journal: Health Place Date: 2006-06-23 Impact factor: 4.078
Authors: S A Strathdee; A Palepu; P G Cornelisse; B Yip; M V O'Shaughnessy; J S Montaner; M T Schechter; R S Hogg Journal: JAMA Date: 1998-08-12 Impact factor: 56.272