Emergency Department High Utilizers among Family Medicine Patients

Journal of the American Board of Family Medicine: JABFM

Denny Fe G. Agana^1¹  Stacey Kirkpatrick^1² 

[1] Department of Community Health and Family Medicine ((DFGA, KL, PC), Department of Epidemiology (DFGA), University of Florida, Gainesville^1;From University of Florida College of Medicine, Gainesville, FL (SK)

关键词: Delivery of Health Care;    Demography;    Emergency Departments;    Medicaid;    Medicare;    Outpatients;    Primary Health Care;    Public Health;   

DOI  :  10.3122/jabfm.2019.02.180184

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

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 ( P < .05). Less than 10% of ED high utilizers were the same over 3 years. 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.

【 授权许可】

CC BY