Determinants of emergency department use and hospitalization among people who inject drugs: A systematic review and meta-analysis

The present study aimed to identify sociodemographic characteristics, risky behaviors, type of drug use, and service use variables associated with emergency department (ED) use and hospitalization among people who inject drugs (PWID). Studies in English published from January 1, 1995, to December 15, 2021, were searched for on <i>PubMed, Scopus, Cochrane</i>, and <i>Web of Science</i> to identify primary studies on ED use and hospitalization among PWID. After a detailed assessment of 17,348 outputs, a total of 19 studies met the eligibility criteria for inclusion in the analysis. Greater risks of ED use and hospitalization among PWID were associated with (i) a history of homelessness, (ii) HIV-positive status, and (iii) injecting drugs more than four times per day. Individuals were more likely to use the ED if they (i) had a history of physical abuse, (ii) were using cocaine and methamphetamine, and (iii) had used primary care services. Women and individuals with chronic physical illnesses were more likely to be hospitalized. The present study is the first to integrate determinants related to ED use and hospitalization based on sociodemographic characteristics, risky behaviors, type of drug, and service use determinants among PWID. To reduce ED use and hospitalization among PWID, the paper also recommends various strategies could be implemented.