Emergency Department Utilization by Adolescents in the United States

Ziv, Amitai; Boulet, Jack; Slap, Gail B.

doi:10.1097/00004583-199904000-00034

Cited by 37 publications

(54 citation statements)

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“…Previous studies have suggested that adolescents overutilize emergency care, 15 but this is the first study to examine emergency department utilization and trends by young adults. Visits from young adults were considerably more likely to occur in the emergency department rather than in an outpatient office setting compared to other ages, including adolescents.…”

Section: Discussionmentioning

confidence: 94%

“…Our analyses concerning the acuity of emergency department visits were based on urgency at triage and hospital admission rates, similar to other studies. 14,15 While these measures are imperfect and do not necessarily equate to appropriateness of ED visits, they do provide basic surrogate measures of acuity. Lastly, we do not have data on patients' past medical history, health status, or whether a patient has an established primary care physician.…”

Section: Discussionmentioning

confidence: 99%

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Dependence on Emergency Care among Young Adults in the United States

et al. 2010

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BACKGROUND: Young adults have a high prevalence of many preventable diseases and frequently lack a usual source of ambulatory care, yet little is known about their use of the emergency department. OBJECTIVE: To characterize care provided to young adults in the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analysis of visits from young adults age 20 to 29 presenting to emergency departments (N=17,048) and outpatient departments (N=14,443) in the National Hospital Ambulatory Medical Care Survey and National Ambulatory Medical Care Survey. MAIN MEASURES: Visits to the emergency department compared to ambulatory offices. RESULTS: Emergency department care accounts for 21.6% of all health care visits from young adults, more than children/adolescents (12.6%; P<0.001) or patients 30 years and over (8.3%; P<0.001). Visits from young adults were considerably more likely to occur in the emergency department for both injury-related and noninjury-related reasons compared to children/adolescents (P<0.001) or older adults (P<0.001). Visits from black young adults were more likely than whites to occur in the emergency department (36.2% vs.19.2%; P< 0.001) rather than outpatient offices. The proportion of care delivered to black young adults in the emergency department increased between 1996 and 2006 (25.9% to 38.5%; P=0.001 for trend). In 2006, nearly half (48.5%) of all health care provided to young black men was delivered through emergency departments. The urgency of young adult emergency visits was less than other age groups and few (4.7%) resulted in hospital admission. CONCLUSIONS: A considerable amount of care provided to young adults is delivered through emergency departments. Trends suggest that young adults are increasingly relying on emergency departments for health care, while being seen for less urgent indications.KEY WORDS: emergency care; ambulatory care; young adults.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Dependence on Emergency Care among Young Adults in the United States

et al. 2010

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“…18,64 In multivariate analysis, the assault-injured youth were less likely to be in school, so they will not have access to schoolbased violence prevention. 65,66 Previous work 14,[67][68][69] also indicates that these highrisk youth, particularly boys, are unlikely to have any other source of medical care.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Youth Seeking Emergency Care for Assault Injuries

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT:The emergency department (ED) is a critical contact location for youth violence interventions. Information on the characteristics of youth, motivations for fights leading to the injury, as well as previous health service utilization of assault-injured youth seeking care is lacking.WHAT THIS STUDY ADDS: Assault-injured youth are characterized in a systematic sample demonstrating frequent ED use and the need to address substance use and lethal means of force in interventions; context and motivations for the fight are novel and will inform intervention efforts. abstract OBJECTIVE: To characterize youth seeking care for assault injuries, the context of violence, and previous emergency department (ED) service utilization to inform ED-based injury prevention.METHODS: A consecutive sample of youth (14-24) presenting to an urban ED with an assault injury completed a survey of partner violence, gun/knife victimization, gang membership, and context of the fight. RESULTS:A total of 925 youth entered the ED with an assault injury; 718 completed the survey (15.4% refused); 730 comparison youth were sampled. The fights leading to the ED visit occurred at home (37.6%) or on streets (30.4%), and were commonly with a known person (68.3%). Fights were caused by issues of territory (23.3%) and retaliation (8.9%); 20.8% of youth reported substance use before the fight. The assault-injured group reported more peer/partner violence and more gun experiences. Assault-injured youth reported higher past ED utilization for assault (odds ratio [OR]: 2.16) or mental health reasons (OR: 7.98). Regression analysis found the assault-injured youth had more frequent weapon use (OR: 1.25) and substance misuse (OR: 1.41).CONCLUSIONS: Assault-injured youth seeking ED care report higher levels of previous violence, weapon experience, and substance use compared with a comparison group seeking care for other complaints. Almost 10% of assault-injured youth had another fight-related ED visit in the previous year, and ∼5% had an ED visit for mental health. Most fights were with people known to them and for well-defined reasons, and were therefore likely preventable. The ED is a critical time to interact with youth to prevent future morbidity. Pediatrics 2014;133:e96-e105 AUTHORS:

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“…A 10-year retrospective analysis established a direct relationship between ED utilisation and population size, and a historical trend towards increasing patient acuity (Meggs, Czaplijski & Benson, 1999). Studies on ED utilisation have also considered specific age groups (Ziv, Boulet & Slap, 1998), ethnic and immigration groups (Wen, Goel & Williams, 1996) as well as diseases of increasing prevalence such as asthma (Goldberg et al, 1998) and injuries (Burt & Fingerhut, 1998).…”

Section: Introductionmentioning

confidence: 99%