Understanding patients with substance abuse and their healthcare pathway by using big data approach: Towards better management in Hong Kong

Abstract

Aim/Objective: Describing the demographic and clinical profiles of patients with substance abuse in Hong Kong to provide insight for the government to guide the development of evidence-based interventions for this population. Methods: A descriptive study was conducted using a cohort of 8,423 patients with a diagnosis of substance abuse. Patients who presented to the Accident and Emergency (A&E) department in Hong Kong public hospitals, between 2004 and 2016 were identified from Clinical Data Analysis and Report System (CDARS) databases. The demographic and clinical profiles of the patients, in addition to trends of their A&E attendances and hospitalizations due to substance abuse were described. Results: The overall trend of substance abuse was a “M” shape curve with two peaks around year 2007 and 2012. Of all patients. 71.8% were men with mean age of 36.7 years, and 28.2% were women with mean age of 33.2 years. About 9.8% of patients were adolescents (<21 years). Among women, 5% abused substances during the period of one year prior to pregnancy and one year after delivery. The most frequently abused substance among the A&E cases were opioids (2,395 cases, 27.1%), followed by ketamine (2,177 cases. 24.6%), barbiturate/hypnotics (656 cases, 7.4%), amphetamines (592 cases, 6.7%) and cocaine (181 cases, 2%). The percent of patients with at least one substance abuse related A&E re-attendance was 19.5%. The mean number of A&E attendance for all patients was 1.93. Approximately 30% of patients with substance abuse had concurrent mental disorders. Totally, 188 patients died due to heroin and opioids abuse, which was 17.7% of total deaths. Conclusions: Although substance abuse has been in a downward trend since 2012, it is still an issue for special groups including adolescents and childbearing age women in Hong Kong. Opioids and ketamine were the two main perpetrators of substance abused.