The effect of inadequate access to healthcare services on emergency room visits. A comparison between physical and mental health conditions

Abstract

This paper estimates the influence of inadequate access to healthcare services on the rate of Emergency Room (ER) hospital visits in Australia. We take micro-data on different types of healthcare shortfalls from the 2012 Australian Survey of Disability, Aging and Carers, and employ Propensity Score Matching (PSM) techniques to identify their effects on ER visits. We find that shortfalls in access to various medical services increases ER visits for individuals with mental and physical conditions by about the same degree. Conversely, inadequate community care services significantly predict ER visits for individuals with physical conditions, but not for persons with mental conditions. The lack of predictive power for inadequate community care for persons with mental health problems is surprising, as “acopia” is thought to be a significant driver of crises that require emergency treatment. We discuss some of the mechanisms that may underpin this finding and address the policy implications of our results. Lastly a number of robustness checks and diagnostics tests are presented which confirm that our modelling assumptions are not violated and that our results are insensitive to the choice of matching algorithms.

Anxiety and alcohol in the working‐age population are driving a rise in mental health‐related emergency department presentations: 15 year trends in emergency department presentations in Western Australia

“…For example, between 2003 and 2011 in the UK, it has been observed that while the diagnosis of anxiety among young people in general practice has remained constant, the reporting of symptoms has increased . It has been suggested that a reduced stigma associated with mental illness has led to an increase in help‐seeking behaviour …”

Inappropriate Attenders: Motives Behind Seeking Emergency Care

“…Extensive research shows that increased availability and accessibility to a GP or after-hours services are associated with significant decreases in ED utilisation (Kraaijvanger et al, 2016;Lowthian et al, 2011;Vecchio, Davies, & Rohde, 2018). A study conducted in NZ by Thornton, Fogarty, Jones, Ragaban, & Simpson (2014) out of Middlemore Hospital looked at the motives behind non-urgent patients (within the Australasian triage scale categories of 3, 4, and 5) self-referring to Middlemore Hospital ED rather than accessing a primary healthcare service.…”

“…Short consultation length may be assisting the misconception that GPs cannot manage complex conditions. Patients with non-urgent health conditions may decide to substitute inaccessible GP services with the ED, even though primary care does have the provisions to manage patients within the Australasian triage scale 3 -5 (Thornton, 2014;Vecchio, Davies & Rohde, 2018).…”

“…There has been an increase in ED use at least once in the last twelve months from 8.5 percent in 2006/07 to 15 percent in 2018/19 (Ministry of Health, 2019) which amounts to 281,985 people (Statistics New Zealand, 2018). Although this would not be entirely due to inappropriate attenders, statistics show that many ED attendees are non-urgent and regularly do not require specific hospital treatment (Vecchio, Davies, & Rohde, 2018). So why do they come?…”

Development and evaluation of a novel caregiver-report tool to assess barriers to physical healthcare for people on the autism spectrum

“…Disparities in access to healthcare can lead to delays in, or non-receipt of, appropriate care ( Lindly, Zuckerman, & Kuhlthau, 2019 ); higher financial burden on the patient ( Drainoni et al, 2006 ); increased use of emergency care ( Brousseau, Bergholte, & Gorelick, 2004 ); higher hospitalisation rates ( Long, Coughlin, & Kendall, 2002 ); higher risk for, and poor management of, chronic illness or comorbid conditions ( Bowles, Naylor, & Foust, 2002 ); greater risk of unmet needs ( Coughlin, Long, & Kendall, 2002 ) and increased burden and cost on the healthcare system due to preventable disease exacerbations and premature deaths ( Vecchio, Davies, & Rohde, 2018 ). Ready access to healthcare on the other hand, is linked to a variety of important outcomes including better health status ( Nicolaidis et al, 2013 ), higher patient satisfaction ( Batbaatar, Dorjdagva, Luvsannyam, Savino, & Amenta, 2017 ), lower hospitalisation rates ( Ansari, Laditka, & Laditka, 2006 ), and reduced burden and cost on the healthcare system ( Reid et al, 2010 ).…”