Use of Emergency Departments for Preventative Care Among Adults in the United States: Estimates From the 2017 National Health Interview Survey

Primm, Kristin; Muraleetharan, Daenuka; Gilreath, Tamika D.

doi:10.1016/j.jemermed.2019.06.004

Cited by 14 publications

(12 citation statements)

References 28 publications

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“…Residents should be encouraged to identify how homelessness and other SDoH affect risk factors for disease, medical decision making, and safe discharge. Housing and food insecurity have also been described as motivators for ED visits 47 and led to increased utilization of the ED for preventive care 48 . Physicians should ask patients about housing status as part of their social history, and it should be routinely considered in treatment, disposition, and follow‐up plans 49 .…”

Section: Key Topics and Teaching Methods For Homelessness In Emmentioning

confidence: 99%

“…Housing and food insecurity have also been described as motivators for ED visits 47 and led to increased utilization of the ED for preventive care. 48 Physicians should ask patients about housing status as part of their social history, and it should be routinely considered in treatment, disposition, and follow‐up plans. 49 Collaboration with social work may be particularly valuable in this effort.…”

Section: Key Topics and Teaching Methods For Homelessness In Emmentioning

confidence: 99%

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Prioritizing homelessness in emergency medicine education: A concept paper

Buono

Salhi

Kimmel

et al. 2022

AEM Education and Training

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Patients experiencing homelessness visit the emergency department (ED) often and have worse clinical outcomes. Caring for this patient population is complex, challenging, and resource-intensive. Emergency medicine (EM) education is lacking in formal curricula on the topic of homelessness, despite benefits for resident morale and patient care. Our goals were to identify a gap in EM education and training of the intersection of housing and health and propose educational topics and teaching methods to be included in residency curricula. Methodology was based on the development of a didactic session at the 2021 SAEM Annual Meeting. A needs assessment was performed through a review of medical education literature, a national survey of EM residency curricula, the individual curricula utilized by respective team members, and perspective from the team's own individual experiences with teaching about homelessness. Topics presented were chosen through discussion between the authors and determined to be common and relevant and cover a broad spectrum of content. The four presented topics included the intersection of COVID-19 and housing, the impact of LGBTQIA+ status on homelessness, housing status related to health system utilization and health outcomes, and housing inequity as a means of perpetuating structural racism. Suggestions for education of these topics included case-based learning, journal clubs, simulation, collaboration with social work, quality improvement projects, and engagement with community leaders. The ED is uniquely positioned to encounter the impacts of homelessness on health. Emergency physicians should be prepared to effectively care for these patients with complex social needs. Structured learning on this topic would benefit EM resident growth and lead to better patient care through improved screening, recognition of risk factors, and use of social resources.

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Section: Key Topics and Teaching Methods For Homelessness In Emmentioning

confidence: 99%

Section: Key Topics and Teaching Methods For Homelessness In Emmentioning

confidence: 99%

Prioritizing homelessness in emergency medicine education: A concept paper

Buono

Salhi

Kimmel

et al. 2022

AEM Education and Training

View full text Add to dashboard Cite

show abstract

“…2017 NHIS includes interview data from 49 067 households of 78 132 individuals. 16 This data, as is the case with other years of NHIS, includes an oversampling of certain subgroups such as racial/ethnic minorities due to interest in the inequalities in health status and health care access in these groups. 15 , 16 Given that the majority composition of enrollees in CHIP include many of these subgroups, NHIS serves as a useful dataset for the present analysis.…”

Section: Methodsmentioning

confidence: 99%

Children’s Health Insurance Status and Emergency Room Utilization: An Examination of Complex Survey Data

Muraleetharan

Gilreath

Primm

et al. 2020

INQUIRY

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Since the Children’s Health Insurance Program’s passage into law in 1997, the program has increased in cost to over $15 billion in recent years. Emergency room usage has also increased throughout the United States, leading to nationwide issues in overcrowding and surges in service costs. This study seeks to examine emergency room utilization of children insured under Children’s Health Insurance Program to determine if Children’s Health Insurance Program enrollees use the emergency room more or less frequently than their privately insured counterparts. The data used in this study were from the 2017 National Health Interview Survey. SAS statistical software was used to conduct a multinomial regression assessing the relationship between insurance type (private v. Children’s Health Insurance Program) and frequency of emergency room utilization over the last 12 months. The analysis results indicate no statistically significant difference between Children’s Health Insurance Program insured and privately insured children in terms of frequency of emergency room utilization and suggest a need to explore other factors that more directly influence Children’s Health Insurance Program costs.

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“…Black and Latino individuals, and those with low income, are more likely to experience barriers to timely medical care that are not cost-related, [8][9][10][11][12] including long waiting times, inconvenient office hours, and lack of transportation. However, it is not known how racial and ethnic disparities in such barriers have changed over the last decades at the national level-and whether there has been any progress in eliminating them.…”

Section: Introductionmentioning

confidence: 99%

Trends in Racial and Ethnic Disparities in Barriers to Timely Medical Care Among US Adults, 1999 to 2018

Caraballo

Ndumele

Roy

et al. 2022

Preprint

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Background: Racial and ethnic disparities in delayed medical care due to reasons not related to cost of care remain understudied. We aimed to describe recent 20-year trends in such disparities. Methods: The study used data from the National Health Interview Survey from 1999 to 2018 and included individuals ≥18 years of age. Respondents were categorized by their sex, income, and self-reported race and ethnicity. The main outcomes were trends in disparities in any of 5 specific barriers to timely medical care: inability to get through by phone, no appointment available soon enough, long waiting times, inconvenient doctor's office/clinic hours, or lack of transportation. Results: The study included 590,603 adults (mean age 46.0 [SE, 0.07] years; 51.9% female). Of these, 4.7% were Asian, 11.8% Black, 13.8% Latino/Hispanic, and 69.7% White. In 1999, the proportion reporting any of the barriers to timely medical care was 7.3% among Asian, 6.9% among Black, 7.9% among Latino/Hispanic, and 7.0% among White individuals (P >0.05 for each difference with White individuals). From 1999 to 2018, this proportion increased across all 4 race/ethnicity groups (P<0.001 for each), slightly increasing the disparities between groups. In 2018, compared with White individuals, the proportion reporting any barrier was 2.1 and 3.1 percentage points higher among Black and Latino/Hispanic individuals (P=0.03 and P=0.001, respectively). The racial/ethnic disparities increased mostly among males and were attenuated when stratified by income level. Conclusions: From 1999 to 2018, barriers to timely medical care increased for all populations with increasing disparities between racial/ethnic groups.

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Use of Emergency Departments for Preventative Care Among Adults in the United States: Estimates From the 2017 National Health Interview Survey

Cited by 14 publications

References 28 publications

Prioritizing homelessness in emergency medicine education: A concept paper

Prioritizing homelessness in emergency medicine education: A concept paper

Children’s Health Insurance Status and Emergency Room Utilization: An Examination of Complex Survey Data

Trends in Racial and Ethnic Disparities in Barriers to Timely Medical Care Among US Adults, 1999 to 2018

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