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Who are Frequent Users of Emergency Rooms?

Who are Frequent Users of Emergency Rooms?. A study of characteristics of frequent users Zeida R. Kon , MPH University of North Texas Health Science Center. Background. 1993-2003- ER visits increased by 26%, totaling approximately 114 million visits per year

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Who are Frequent Users of Emergency Rooms?

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  1. Who are Frequent Users of Emergency Rooms? A study of characteristics of frequent users Zeida R. Kon, MPH University of North Texas Health Science Center

  2. Background • 1993-2003- ER visits increased by 26%, totaling approximately 114 million visits per year • ERs reported being at or over capacity 50% of the time • Hospitals now employing cost-savings and cost-cutting strategies

  3. Background • Contrary to common perceptions, the literature demonstrates frequent users of the ER are: • Insured (publicly insured) • U.S. citizens • African Americans followed by Whites • English as primary language • Have a usual source of care

  4. Background Cont. • Low socio-economic status • Poor physical health • Poor mental health • Single, single parent or divorced • Choose ER due to preference (convenience)

  5. Purpose • To explore the characteristics of individuals visiting the ER by comparing frequent users and non-frequent users • To explore definition of frequent ER users • Propose actions by hospitals and policy makers to alleviate overburdened ERs in the U.S.

  6. Methods • Center for Studying Health System Change 2001-2002 Community Tracking Study • Random-digit dialing survey in 60 randomly selected U.S. sites • Sample size: 59,725

  7. Methods Cont. • Dependent variable: ER frequency • Non-frequent users: 1-2 visits • Frequent users: 3+ visits • Independent variables: • Socio-economic status • Insurance status • Usual source of care • Marital status • Number of children

  8. Sociodemographic Characteristics by Frequency of ER Use

  9. Access and Health Characteristics by Frequency of ER Use

  10. Multivariate Adjusted Odds Ratios (95% CI) of Frequent ER Use (3+)‏

  11. Discussion • Study confirms previous findings • Frequent ER users more likely to be: • publicly insured • have a usual source of care • have low educational attainment • female and single • poor physical/mental health • low-income • Rationale for broadening the range of frequent user visits to 3+

  12. Policy Implications • This definition of frequent users includes a large enough population to warrant action on both the part of hospitals and policy makers • Hospital: • Build permanent partnership public health, mental health and social service agencies • Community clinics • Policy: • Guidelines that encourage above actions • Best practices for hospitals to employ

  13. Acknowledgements • Co-author: Jim P. Stimpson, Ph.D., Assistant Professor, University of North Texas Health Science Center

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