Emergency Department Bridge Model and Health Services Use Among Patients With Opioid Use Disorder

Area of Science:

• Public Health
• Emergency Medicine
• Addiction Medicine

Background:

• Effectiveness of bridge clinics for opioid use disorder (OUD) transitional care from emergency departments (EDs) is understudied.
• OUD patients in EDs require effective transitional care strategies.

Purpose of the Study:

• To assess the impact of bridge clinic referral on health service utilization among OUD patients identified in the ED.
• To evaluate the effect of bridge clinic intervention on linkage to long-term care, ED use, and inpatient admissions.

Main Methods:

• Retrospective analysis of patients aged 18+ with active OUD receiving medication in the ED (Jan 2013-Aug 2022).
• Intervention group: patients referred to bridge clinic (from Jan 2021). Control group: propensity score-matched patients receiving usual care (pre-Jan 2021).
• Comparison of outcomes (linkage to long-term care, ED use, inpatient admission) within 120 days using risk differences.

Main Results:

• Bridge clinic referral increased linkage to long-term care by 25% (95% CI: 20%, 30%).
• ED use risk increased by 7.5% (95% CI: 1.6%, 13%) with bridge clinic referral.
• Overall inpatient admission risk decreased slightly (-1.9%, 95% CI: -5.9%, 2.1%), but increased for patients with serious mental illness and decreased for those without.

Conclusions:

• Bridge clinic referral is effective in enhancing linkage to long-term care for OUD patients from EDs.
• Differential impacts on inpatient admissions for patients with and without serious mental illness highlight specific needs and potential gaps in care.
• Further investigation into unmet needs for OUD patients with serious mental illness is warranted.