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2015 ; 94
(29
): e1205
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Prevalence of and Predictors for Frequent Utilization of Emergency Department: A
Population-Based Study
#MMPMID26200638
Ko M
; Lee Y
; Chen C
; Chou P
; Chu D
Medicine (Baltimore)
2015[Jul]; 94
(29
): e1205
PMID26200638
show ga
Frequent emergency department (ED) users contribute to a disproportionate number
of ED visits that consume a substantial amount of medical resources.
Additionally, people with frequent ED visits may be at greater risks of illnesses
and injury and are vulnerable to even more severe health events. We conducted,
based on a nationally representative sample, a population-based study to estimate
the prevalence of frequent ED users among all ED users, and to explore factors
associated with frequent ED visits. This is a population-based cross-sectional
study. Data of 1 million people randomly selected from all beneficiaries of
Taiwan's National Health Insurance claim database in 2010 were analyzed to
estimate the distribution of ED visit among ED users. Multivariate logistic
regression was employed to calculate the independent associations of factors with
prevalence of frequent (4-12 ED visits per year) and highly frequent (>12 ED
visits per year) ED visits. Of the 1 million beneficiaries 170,475 subjects used
ED service in 2010 and 103,111 (60.5%), 37,964 (22.3%), 14,881 (8.7%), 14,041
(8.2%), and 460 (0.3%) subjects had 1, 2, 3, 4 to 12, and more than 12 ED visits,
respectively. ED users with 4 to 12 visits and those with >12 visits
disproportionally accounted for 24.1% and 3.0%, respectively, of all ED visits in
2010. We noted significant associations of frequent ED visit with a number of
factors including socio-demographics, health care utilization, and comorbidity.
Among them, the most increased adjusted odds ratio (AOR) was noted for
hospitalization during the past year (AOR = 1.85) and younger ages (1-6 years)
(AOR = 1.84). On the contrary, the significant predictors for highly frequent ED
visit with greater AOR included hospitalization during the past year (AOR =
3.95), > 12 outpatient visits during the past year (AOR = 2.66), and a history of
congestive heart failure (AOR = 2.64) and psychiatric disorders (AOR = 2.35).
People admitted and with frequent outpatient visits were at greater risk of
frequent ED visit. Because people with a history of various comorbidities were
also vulnerable to become frequent ED users, careful management of those
comorbidities by clinicians may help further reduce the likelihood of frequent ED
visit.
|Adolescent
[MESH]
|Adult
[MESH]
|Age Factors
[MESH]
|Aged
[MESH]
|Child
[MESH]
|Child, Preschool
[MESH]
|Comorbidity
[MESH]
|Cross-Sectional Studies
[MESH]
|Emergency Service, Hospital/*statistics & numerical data
[MESH]
|Female
[MESH]
|Health Services/statistics & numerical data
[MESH]
|Humans
[MESH]
|Infant
[MESH]
|Insurance Claim Review/statistics & numerical data
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Odds Ratio
[MESH]
|Public Assistance/statistics & numerical data
[MESH]