TY - JOUR
T1 - Factors Associated with Frequent Emergency Department Use in the Medicare Population
AU - Colligan, Erin Murphy
AU - Pines, Jesse M.
AU - Colantuoni, Elizabeth
AU - Wolff, Jennifer L.
N1 - Funding Information:
This work was funded through the Department of Health and Human Services Pathways Program and an AHRQ T32 student grant.
Publisher Copyright:
© SAGE Publications.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Frequent emergency department (ED) use is a public health and policy relevant concern but has not previously been examined in the Medicare population. We conducted a retrospective, claims-based analysis of a nationally representative 20% sample of fee-for-service Medicare beneficiaries in 2010 (n = 5,778,038) to examine frequent ED use. We used multinomial logistic regression to study the relationship between frequent ED use and sociodemographic, outpatient care, and clinical characteristics. Factors that were most strongly associated with frequent ED use included being age 18 to 34 years compared with 65 to 74 years (relative risk ratio = 20.5, confidence interval [CI; 19.7, 21.3]) and mental illness (relative risk ratio = 6.8, CI [6.7, 6.9]). Low versus high continuity of care was associated with 24% (95% CI [1.21, 1.26]) greater risk of frequent compared with non-ED use. Although clinical and demographic characteristics are most strongly associated with frequent ED use, poor continuity of care is also a contributor.
AB - Frequent emergency department (ED) use is a public health and policy relevant concern but has not previously been examined in the Medicare population. We conducted a retrospective, claims-based analysis of a nationally representative 20% sample of fee-for-service Medicare beneficiaries in 2010 (n = 5,778,038) to examine frequent ED use. We used multinomial logistic regression to study the relationship between frequent ED use and sociodemographic, outpatient care, and clinical characteristics. Factors that were most strongly associated with frequent ED use included being age 18 to 34 years compared with 65 to 74 years (relative risk ratio = 20.5, confidence interval [CI; 19.7, 21.3]) and mental illness (relative risk ratio = 6.8, CI [6.7, 6.9]). Low versus high continuity of care was associated with 24% (95% CI [1.21, 1.26]) greater risk of frequent compared with non-ED use. Although clinical and demographic characteristics are most strongly associated with frequent ED use, poor continuity of care is also a contributor.
KW - Medicare
KW - continuity of care
KW - disabled
KW - elderly
KW - emergency department
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U2 - 10.1177/1077558716641826
DO - 10.1177/1077558716641826
M3 - Article
C2 - 27030234
AN - SCOPUS:85018726397
SN - 1077-5587
VL - 74
SP - 311
EP - 327
JO - Medical Care Research and Review
JF - Medical Care Research and Review
IS - 3
ER -