Predictors of Multiple Emergency Department Utilization Among Frequent Emergency Department Users in 3 States
Bibliographic Data
| ID | 9103441 |
|---|---|
| Authors | Theodoros V Giannouchos (0000-0002-1574-6767, Department of Health Policy & Management, School of Public Health, corresponding author), D Washburn (0000-0002-8820-8687, corresponding author), David J Washburn (Department of Health Policy & Management, School of Public Health), Hye-Chung Kum (Department of Health Policy & Management, School of Public Health), Hye‐Chung Kum (0000-0002-6882-8053, Texas A&M University, corresponding author), William M Sage (0000-0003-2098-6199, Department of Surgery and Perioperative Care, Dell Medical School), Robert L Ohsfeldt (0000-0002-6117-056X, Department of Health Policy & Management, School of Public Health, corresponding author) |
| Year | 2020 |
| Volume | 58 |
| Issue | 2 |
| Pages | 137-145 |
| Publication date | 2020-02-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000001228 |
| PMID | 31651740 |
| OpenAlex | W2981977286 |
| Language | EN |
| Citations received | 4 |
| References cited | 40 |
BACKGROUND: Research on frequent emergency department (ED) use shows that a subgroup of patients visits multiple EDs. This study characterizes these individuals. OBJECTIVE: The objective of this study was to determine how many frequent ED users seek care at multiple EDs and to identify sociodemographic, clinical, and contextual factors associated with such behavior. RESEARCH DESIGN: We used the 2011-2014 Healthcare Cost and Utilization Project State Emergency Department Databases data on all outpatient ED visits in New York, Massachusetts, and Florida. We studied all adult ED users with ≥5 visits in a year and defined multisite use as visits to ≥3 different sites. We estimated predictors of multisite use with multivariate logistic regressions. RESULTS: Across all 3 states, 1,033,626 frequent users accounted for 7,613,077 ED visits. Of frequent users, 25% were multisite users, accounting for 30% of the visits studied. Frequent users with at least 1 visit for mental health or substance use-related diagnosis were more likely to use multiple sites. Uninsured frequent users and those with public insurance were associated with less use of multiple EDs than those with private coverage while lacking consistent coverage by the same insurance within each year were associated with using multiple sites. CONCLUSIONS: Health policy interventions to reduce duplicative or unnecessary ED use should apply a population health perspective and engage multiple hospitals. Community-level preventive approaches and a stronger infrastructure for mental health and substance use are essential to mitigate multisite ED use
Emergency department · Medical emergency · Emergency and Acute Care Studies · Emergency Medicine · Homelessness and Social Issues · Medicine · Mental Health Treatment and Access · Nursing
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| Unique citing works | 4 |
|---|---|
| Citations per year | 0,8 |
| Citation span | 2021 - 2024 (4) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 4 |