ED utilization: The effect of changing demographics from 1992 to 2000

Reeder, Timothy; Locascio, Elizabeth; Tucker, J.L.; Czaplijski, Thomas; Benson, Nicholas H.; Meggs, William J.

doi:10.1053/ajem.2002.35462

Cited by 24 publications

(15 citation statements)

References 22 publications

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“…Several studies, including some from countries providing universal insurance, cite limited access to a primary care physician (PCP) or General Practitioner (GP) as patients' reasons for attending an ED 8 28 50–53. In Australia, this is likely to be a consequence of reduced availability of and access to GPs, arising from medical workforce shortages and changes in healthcare practice, including a decline in the rate of home and nursing home visits54–56 (facilities providing nursing care for residents).…”

Section: Findings and Discussionmentioning

confidence: 99%

Systematic review of trends in emergency department attendances: an Australian perspective

Lowthian

Curtis

Cameron

et al. 2010

Emergency Medicine Journal

190

157

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Section: Findings and Discussionmentioning

confidence: 99%

Systematic review of trends in emergency department attendances: an Australian perspective

Lowthian

Curtis

Cameron

et al. 2010

Emergency Medicine Journal

190

157

View full text Add to dashboard Cite

“…Increased parental ER utilization is significantly associated with increased childhood ER utilization (Mistry et al, 2005). Increased age, increased acuity, being an African American, living in a rural area, and having limited access to primary-care physicians, all contribute to increased ER demand (Meggs et al, 1999;Phelps et al, 2000;Burt and McCaig, 2001;Reeder et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Utilization of the emergency room: impact of geographic distance

Lee

Sung

Ward³

et al. 2007

Geospat Health

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Abstract. The aim of this study was to estimate the distance Mississippi patients must travel to access hospital-based emergency rooms (ERs) and to determine whether an association exists between geographic distance and ER utilization. To that end, great circle distances between Census Block Group Centroid Points and 89 hospitals with emergency departments were calculated for the State of Mississippi. Data on the socio-demographic characteristics of each block group came from the 2000 US Census data. Logistic regression analyses were conducted to test if there was any association between ER utilization and travel distance. Compared to the national benchmark of 35.7%, more than one in two (56.7%), or 1,612,762 Mississippians visited ERs in 2003 with an estimated 6.1 miles per person annual travel for this purpose. The majority of the target population (54.9%) was found to live within 5 miles of hospitals with ERs. Logistic analyses revealed that block groups associated with less miles traveled to hospitals with ERs had a higher proportion of African Americans, impoverished people, female householders, people with more than 12 years education, people older than 65 years, people with high median house values, and people without employment. Twenty-nine of the 89 hospitals (33%) providing ER care in Mississippi were found to be in areas with above-average ER utilization rates. These hospitals served a smaller geographical area (28% of the total) but had a greater proportion of visitors (57%) and served a higher percentage (37%) of the state population. People in areas served by the less utilized ERs traveled more miles to be cared for (7.1 miles vs 5.4 miles; p<0.0001). Logistic regression analysis revealed that shorter distances were associated with increased use of the ERs, even after controlling for socio-demographic factors. The conclusion is that Mississippi ERs are typically located in block groups with higher percentages of disadvantaged residents and that people in these areas are more likely to utilize ER services. Our data suggest that the geographical distance has an impact on ER utilization, especially by reducing utilization in disadvantaged block group areas. Disadvantaged persons living near ER hospitals (<5 miles) were found to be more likely to utilize the ER services. Geographic distance should therefore be considered when planning state-wide ER programmes for disadvantaged populations.

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“…3 Several prior studies observed that the elderly use the ED frequently and that visit rates among the elderly have been increasing over time. [10][11][12][13] This led to concern that population aging in and of itself could cause ED visit frequency to increase faster than population growth, requiring more per capita emergency care capacity.…”

Section: Discussionmentioning

confidence: 99%

“…We also estimated the total amount of time that patients would spend in EDs, given that the elderly present with more complex problems and typically have longer visits. 12 We refer to the total time spent by patients in EDs throughout the country as "aggregate visit length." We calculated the length of each visit as the total lengthof-stay minus waiting time.…”

Section: Study Data and Methodsmentioning

confidence: 99%

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Population Aging And Emergency Departments: Visits Will Not Increase, Lengths-Of-Stay And Hospitalizations Will

et al. 2013

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With US emergency care characterized as "at the breaking point," we studied how the aging of the US population would affect demand for emergency department (ED) services and hospitalizations in the coming decades. We applied current age-specific ED visit rates to the population structure anticipated by the Census Bureau to exist through 2050. Our results indicate that the aging of the population will not cause the number of ED visits to increase any more than would be expected from population growth. However, the data do predict increases in visit lengths and the likelihood of hospitalization. As a result, the aggregate amount of time patients spend in EDs nationwide will increase 10 percent faster than population growth. This means that ED capacity will have to increase by 10 percent, even without an increase in the number of visits. Hospital admissions from the ED will increase 23 percent faster than population growth, which will require hospitals to expand capacity faster than required by raw population growth alone.

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ED utilization: The effect of changing demographics from 1992 to 2000

Cited by 24 publications

References 22 publications

Systematic review of trends in emergency department attendances: an Australian perspective

Systematic review of trends in emergency department attendances: an Australian perspective

Utilization of the emergency room: impact of geographic distance

Population Aging And Emergency Departments: Visits Will Not Increase, Lengths-Of-Stay And Hospitalizations Will

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