Background
Emergency department use is common among pregnant women. Non-urgent emergency department use may represent care that would be better provided by an established obstetric provider in an ambulatory setting.
Objective
To identify socio-demographic factors associated with non-urgent emergency department use in pregnancy.
Study Design
This is a cross-sectional study of women recruited during their postpartum hospitalization. Data regarding prenatal care and emergency department visits was collected from medical records; participants completed a survey with questions regarding demographics and emergency department use. Urgency of an emergency department visit was pre-specified based on a-priori criteria abstracted from medical record review. Women with any non-urgent emergency department use were compared with women without non-urgent emergency department use. Logistic regression was performed to identify factors associated with non-urgent emergency department use.
Results
Two hundred and thirty-three women participated in this study; 197 (84%) received care in the emergency department during pregnancy. Eighty-three (35.6%) women had at least one visit to the emergency department that was non-urgent. In regression analysis, increased odds of non-urgent emergency department use was associated with a preferred language other than English (OR 2.02, 95% CI 1.01-4.05) and lack of private insurance (OR 5.55, 95% CI 2.54-12.12). The two most common reasons for presentation to the emergency department were concern that there was an emergency (45%) or being referred by a healthcare provider (36%).
Conclusion
Women frequently use the emergency department during pregnancy, including visits for non-urgent indications. Identifying risk factors for non-urgent emergency department use in pregnancy is important for identifying women likely to use the emergency department, including for non-urgent visits, and the development of strategies to decrease non-urgent emergency department utilization in pregnancy.
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