TY - JOUR
T1 - Western Australia remote aeromedical substance use disorders outcomes
AU - Faint, Nicholas
AU - Coleman, Mathew
AU - Spring, Breeanna
AU - Richardson, Alice
AU - Thornton, Ashleigh
AU - Bacon, Donna
AU - Kumaradevan, Santharajah
AU - Gardiner, Fergus W.
N1 - Publisher Copyright:
© 2023 Royal Australasian College of Physicians.
PY - 2024/5
Y1 - 2024/5
N2 - Introduction: Substance use disorders (SUDs) cause significant harm to regional Australians, who are more likely to misuse alcohol and other drugs (AODs) and encounter difficulty in accessing treatment services. The primary aims of this study were to describe the demographics of patients aeromedically retrieved from regional locations and compare hospital outcomes with a metropolitan-based cohort. Aims: Retrospective case-controlled cohort study. Participants were aeromedically retrieved within Western Australia for SUDs between 1 July 2014 and 30 June 2019. Retrieved patients were case-matched based on age and hospital discharge diagnosis. Descriptive statistics and χ2 analysis were used to summarise the findings. Results: One hundred thirty-six (91.3%) aeromedical retrievals were found, with the majority being male (n = 95; 69.9%). These were case-matched to 427 metropolitan patients, the majority male (n = 321; 75.2%). Retrieved patients were more likely (all P < 0.05) Indigenous (odds ratio [OR], 9.35 [95% confidence interval (CI), 5.96–14.85]), unemployed (OR, 2.9 [95% CI, 1.41–6.80]), referred to a tertiary hospital (OR, 2.18 [95% CI, 1.24–3.86]) and to stay longer in hospital (OR, 1.08 [95% CI, 1.02–1.14]). Discussion: Findings highlight that unmarried and/or unemployed males were overrepresented in the retrieval group, with over half identifying as Indigenous. Regional variation in retrievals was noted, while amphetamine-type stimulants featured prominently in the retrieval cohort, who experienced longer hospital stays and more restrictive treatment. Conclusions: Comparing clinical outcomes for retrieved regional patients experiencing SUDs, service design and delivery should focus on offering culturally safe care for Indigenous people, catering for regional health care catchment areas, while ideally adopting collaborative and integrated approaches between AODs and mental health services.
AB - Introduction: Substance use disorders (SUDs) cause significant harm to regional Australians, who are more likely to misuse alcohol and other drugs (AODs) and encounter difficulty in accessing treatment services. The primary aims of this study were to describe the demographics of patients aeromedically retrieved from regional locations and compare hospital outcomes with a metropolitan-based cohort. Aims: Retrospective case-controlled cohort study. Participants were aeromedically retrieved within Western Australia for SUDs between 1 July 2014 and 30 June 2019. Retrieved patients were case-matched based on age and hospital discharge diagnosis. Descriptive statistics and χ2 analysis were used to summarise the findings. Results: One hundred thirty-six (91.3%) aeromedical retrievals were found, with the majority being male (n = 95; 69.9%). These were case-matched to 427 metropolitan patients, the majority male (n = 321; 75.2%). Retrieved patients were more likely (all P < 0.05) Indigenous (odds ratio [OR], 9.35 [95% confidence interval (CI), 5.96–14.85]), unemployed (OR, 2.9 [95% CI, 1.41–6.80]), referred to a tertiary hospital (OR, 2.18 [95% CI, 1.24–3.86]) and to stay longer in hospital (OR, 1.08 [95% CI, 1.02–1.14]). Discussion: Findings highlight that unmarried and/or unemployed males were overrepresented in the retrieval group, with over half identifying as Indigenous. Regional variation in retrievals was noted, while amphetamine-type stimulants featured prominently in the retrieval cohort, who experienced longer hospital stays and more restrictive treatment. Conclusions: Comparing clinical outcomes for retrieved regional patients experiencing SUDs, service design and delivery should focus on offering culturally safe care for Indigenous people, catering for regional health care catchment areas, while ideally adopting collaborative and integrated approaches between AODs and mental health services.
KW - air ambulance
KW - mental health
KW - rural and remote
KW - substance use disorder
UR - http://www.scopus.com/inward/record.url?scp=85163095599&partnerID=8YFLogxK
U2 - 10.1111/imj.16140
DO - 10.1111/imj.16140
M3 - Article
SN - 1444-0903
VL - 54
SP - 86
EP - 95
JO - Internal Medicine Journal
JF - Internal Medicine Journal
IS - 1
ER -