Smoking, Drug Use Significantly Increases ER Visits

It is well known that smokers and drug users are plagued with varying health issues. Supporting this idea is a University of Buffalo (UB) study, which has not only found that they visit the emergency room (ER) at alarming rates, but also disputed that people are bypassing primary care practices for hospital care.

The research, published in Nursing Research, reported that smoking and drug use triples ER visits. Furthermore, smokers were determined to be as much as four times more likely to be ER “super-users” than non-smokers.

“There are a few super-users who have been in the ER 40 or 50 times, but when we step back and look at the whole population, we see a different pattern,” Jessica Castner, assistant professor in the UB School of Nursing and the study’s lead author, said in a statement.

Castner and her colleagues conducted a retrospective analysis of 2009 Medicaid claims in two counties in western NY. The claims were separated into 4 groups based on disease complexity: healthy; at risk for chronic disease; diagnosed with chronic disease; and diagnosed with a system failure, the release pointed out.

Identifying 56,491 claims from patients 18—64 years old, the investigators found increased treat-and-release emergency department (ED) based on issues stemming from psychiatric diagnoses (ORs = 1.4—2.3), substance abuse (ORs = 2.4—3.8), and smoking (ORs = 1.7–4.0). Furthermore, they noted Medicaid recipients with a history of behavioral health issues were also more likely to frequently visit the ED.

Moreover, their report also shed debunked the idea that there are influxes of patients that disregard primary care in favor of the ER, but instead they found Americans dealing with chronic diseases are using both facilities equally. According to the UB statement, the “super-user epidemic” premise is conflated by an overall increase in the cost of medical care.

“People aren’t replacing their doctor; they are sicker, have more chronic diseases and are using everything more,” Castner explained.

Moving forward, the researchers plan further to investigate ED use among individuals with chronic diseases.