Emergency Department High Utilizers among Family Medicine Patients.
Adult
Aged
Chronic Pain
/ epidemiology
Emergency Service, Hospital
/ statistics & numerical data
Family Practice
/ statistics & numerical data
Female
Health Services Accessibility
/ statistics & numerical data
Humans
Male
Middle Aged
Retrospective Studies
Substance-Related Disorders
/ epidemiology
United States
Delivery of Health Care
Demography
Emergency Departments
Medicaid
Medicare
Outpatients
Primary Health Care
Public Health
Journal
Journal of the American Board of Family Medicine : JABFM
ISSN: 1558-7118
Titre abrégé: J Am Board Fam Med
Pays: United States
ID NLM: 101256526
Informations de publication
Date de publication:
Historique:
received:
29
06
2018
revised:
26
11
2018
accepted:
28
11
2018
entrez:
10
3
2019
pubmed:
10
3
2019
medline:
14
4
2020
Statut:
ppublish
Résumé
Increases in emergency department (ED) use are contributing to inefficient health care spending and becoming a public health concern. Previous studies have identified characteristics of ED high utilizers aimed at designing interventions to improve efficiency. We aim to expand on these findings in a family medicine outpatient population. We conducted a retrospective analysis on a population of ED high utilizers, defined as those who had been to the ED 6 or more times in 1 year, including medical and demographic characteristics from 2015 to 2017. Compared with our source population, ED high utilizers were most commonly female, African American, or single and insured by Medicare or Medicaid. They did not have a chronic pain or substance use diagnosis, but more than half had a psychiatric condition. The only demographic characteristic that changed over time was home location from 2015 to 2017 ( Most demographic characteristics did not change over time, whereas individuals did change. Interventions aimed at improving efficiency of ED use should be geared toward unchanging characteristics rather than individuals. The only demographic characteristic that did change significantly was home location that correlated in time with the availability of new EDs providing support for a theory of supply-sensitive ED use.
Sections du résumé
BACKGROUND
Increases in emergency department (ED) use are contributing to inefficient health care spending and becoming a public health concern. Previous studies have identified characteristics of ED high utilizers aimed at designing interventions to improve efficiency. We aim to expand on these findings in a family medicine outpatient population.
METHODS
We conducted a retrospective analysis on a population of ED high utilizers, defined as those who had been to the ED 6 or more times in 1 year, including medical and demographic characteristics from 2015 to 2017.
RESULTS
Compared with our source population, ED high utilizers were most commonly female, African American, or single and insured by Medicare or Medicaid. They did not have a chronic pain or substance use diagnosis, but more than half had a psychiatric condition. The only demographic characteristic that changed over time was home location from 2015 to 2017 (
CONCLUSIONS
Most demographic characteristics did not change over time, whereas individuals did change. Interventions aimed at improving efficiency of ED use should be geared toward unchanging characteristics rather than individuals. The only demographic characteristic that did change significantly was home location that correlated in time with the availability of new EDs providing support for a theory of supply-sensitive ED use.
Identifiants
pubmed: 30850463
pii: 32/2/264
doi: 10.3122/jabfm.2019.02.180184
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
264-268Informations de copyright
© Copyright 2019 by the American Board of Family Medicine.
Déclaration de conflit d'intérêts
Conflict of interest: none declared.