Characteristics of youth with an incident ED visit stratified by immigration status and prior outpatient care for mental health–related concerns (2010–2014)
| Characteristic | Non-immigrants n = 109 977 | Non-refugee immigrants n = 6680 | Refugee immigrants n = 2194 | SD† | |||
|---|---|---|---|---|---|---|---|
| No previous outpatient visit | Previous outpatient visit | No previous outpatient visit | Previous outpatient visit | No previous outpatient visit | Previous outpatient visit | ||
| n (row % within non-immigrants) | n (row % within non-refugee immigrants) | n (row % within refugee immigrants)* | |||||
| Overall | 56 399 (51.3) | 53 578 (48.7) | 3845 (57.6) | 2835 (42.4) | 1344 (61.3) | 850 (38.7) | - |
| Age group, yr | |||||||
| 10–13 | 4223 (47.0) | 4771 (53.0) | 141 (55.7) | 112 (44.3) | 39 (56.5) | 30 (43.5) | 0.10 |
| 14–17 | 18 894 (51.0) | 18 145 (49.0) | 970 (60.5) | 632 (39.5) | 323 (68.4) | 149 (31.6) | 0.01 |
| 18–21 | 22 305 (53.6) | 19 327 (46.4) | 1678 (59.1) | 1159 (40.9) | 586 (63.8) | 333 (36.2) | 0.07 |
| 22–24 | 10 977 (49.2) | 11 335 (50.8) | 1056 (53.1) | 932 (46.9) | 396 (54.0) | 338 (46.0) | 0.06 |
| Sex | |||||||
| Female | 28 817 (49.0) | 29 948 (51.0) | 1949 (55.6) | 1556 (44.4) | 674 (59.2) | 464 (40.8) | 0.10 |
| Male | 27 582 (53.9) | 23 630 (46.1) | 1896 (59.7) | 1279 (40.3) | 670 (63.4) | 386 (36.6) | |
| Income quintile | |||||||
| 1 (low) | 13 576 (53.5) | 11 793 (46.5) | 1004 (58.9) | 702 (41.1) | 556 (61.1) | 354 (38.9) | 0.06 |
| 2 | 11 043 (51.0) | 10 604 (49.0) | 798 (58.3) | 571 (41.7) | 336 (63.6) | 192 (36.4) | 0.00 |
| 3 | 10 665 (51.1) | 10 208 (48.9) | 764 (58.6) | 540 (41.4) | 213 (60.7) | 138 (39.3) | 0.00 |
| 4 | 10 705 (50.1) | 10 661 (49.9) | 753 (57.0) | 567 (43.0) | 153 (60.5) | 100 (39.5) | 0.03 |
| 5 (high) | 10 410 (50.2) | 10 312 (49.8) | 526 (53.6) | 455 (46.4) | 86 (56.6) | 66 (43.4) | 0.03 |
| Rural | |||||||
| No | 49 753 (50.3) | 49 182 (49.7) | 3798 (57.5) | 2804 (42.5) | NR | NR | 0.19 |
| Yes | 6646 (60.2) | 4396 (39.8) | 47 (60.3) | 31 (39.7) | NR | NR | – |
| Usual provider of care | |||||||
| No | 5351 (94.2) | 329 (5.8) | 269 (94.4) | 16 (5.6) | 102 (98.1) | NR | 1.15 |
| Yes | 51 048 (48.9) | 53 249 (51.1) | 3576 (55.9) | 2819 (44.1) | 1242 (59.4) | NR | – |
| Primary care model | |||||||
| GP or FP enrolment program | 44 539 (48.9) | 46 567 (51.1) | 3053 (55.5) | 2446 (44.5) | 1001 (58.8) | NR | 0.28 |
| GP or FP fee-for-service | 4470 (54.7) | 3700 (45.3) | 447 (60.7) | 289 (39.3) | 197 (62.3) | NR | 0.08 |
| Pediatrician | 2039 (40.6) | 2982 (59.4) | 76 (47.5) | 84 (52.5) | 44 (61.1) | NR | 0.23 |
| No UPC | 5351 (94.2) | 329 (5.8) | 269 (94.4) | 16 (5.6) | 102 (98.1) | NR | 1.15 |
| Mental health diagnosis at ED visit | |||||||
| Acute stress | 7632 (47.5) | 8447 (52.5) | 429 (52.6) | 387 (47.4) | 151 (62.1) | 92 (37.9) | 0.09 |
| Anxiety | 11 298 (50.4) | 11 125 (49.6) | 699 (53.1) | 617 (46.9) | 286 (57.3) | 213 (42.7) | 0.03 |
| Mood or affective disorder | 7731 (38.0) | 12 628 (62.0) | 388 (37.8) | 638 (62.2) | 100 (38.8) | 158 (61.2) | 0.34 |
| Residual self-harm | 5399 (50.8) | 5221 (49.2) | 459 (62.0) | 281 (38.0) | 208 (69.8) | 90 (30.2) | 0.00 |
| Psychotic disorders | 1268 (40.7) | 1847 (59.3) | 181 (43.7) | 233 (56.3) | 62 (43.1) | 82 (56.9) | 0.22 |
| Substance-related disorders | 19 358 (66.8) | 9608 (33.2) | 1526 (75.5) | 496 (24.5) | 485 (74.5) | 166 (25.5) | 0.44 |
| Other | 3713 (44.1) | 4702 (55.9) | 163 (47.1) | 183 (52.9) | 52 (51.5) | 49 (48.5) | 0.16 |
| Admitted to hospital | |||||||
| No | 50 527 (53.3) | 44 286 (46.7) | 3338 (60.3) | 2196 (39.7) | 1161 (62.8) | 688 (37.2) | 0.30 |
| Yes | 5872 (38.7) | 9292 (61.3) | 507 (44.2) | 639 (55.8) | 183 (53.0) | 162 (47.0) | – |
| Service time ED visit | |||||||
| Daytime | 13 778 (45.3) | 16 630 (54.7) | 726 (47.4) | 805 (52.6) | 256 (53.6) | 222 (46.4) | 0.25 |
| Evening and after hours | 19 547 (48.0) | 21 165 (52.0) | 1271 (53.3) | 1115 (46.7) | 481 (62.6) | 287 (37.4) | 0.09 |
| Night | 23 074 (59.4) | 15 783 (40.6) | 1848 (66.9) | 915 (33.1) | 607 (64.0) | 341 (36.0) | 0.27 |
| Time since immigration, yr | |||||||
| Recent (0 to ≤ 5) | – | – | 558 (64.1) | 313 (35.9) | 222 (64.9) | 120 (35.1) | 0.14 |
| Intermediate (> 5 to ≤ 10) | – | – | 1167 (59.1) | 806 (40.9) | 461 (64.5) | 254 (35.5) | 0.06 |
| Long-term (> 10) | – | – | 2120 (55.3) | 1716 (44.9) | 661 (58.1) | 476 (41.9) | 0.12 |
| Region of origin | |||||||
| Africa | – | – | 266 (61.1) | 169 (38.9) | 274 (65.4) | 145 (34.6) | 0.11 |
| Central America | – | – | 457 (60.8) | 295 (39.2) | 84 (64.6) | 46 (35.4) | 0.06 |
| East Asia and Pacific | – | – | 748 (61.7) | 464 (38.3) | 55 (62.5) | 33 (37.5) | 0.08 |
| Eastern Europe/Central Asia | – | – | 500 (52.7) | 449 (47.3) | 158 (57.2) | 118 (42.8) | 0.11 |
| Middle East | – | – | 434 (54.7) | 359 (45.3) | 177 (57.8) | 129 (42.2) | 0.07 |
| South America | – | – | 249 (57.4) | 185 (42.6) | 119 (62.0) | 73 (38.0) | 0.01 |
| South Asia | – | – | 710 (60.9) | 456 (39.1) | 376 (61.9) | 231 (38.1) | 0.07 |
| US/UK/Western Europe | – | – | 480 (51.2) | 457 (48.8) | 101 (57.7) | 74 (42.3) | 0.14 |
Note: ED = emergency department, FP = family practitioner, GP = general practitioner, NR = not reported, SD = standardized difference, UPC = usual provider of care.
↵* Some rates for subgroups not reported (NR) owing to small cell sizes. Institutional policy requires suppression of cell sizes < 6.
↵† Standardized differences for categorical variables compare percentage of “no prior outpatient visits” between given level of the covariate versus all other levels of the covariate.