TY - JOUR
T1 - Risk Factors for Persistent Frequent Emergency Department Use in Medicare Beneficiaries
AU - Colligan, Erin M.
AU - Pines, Jesse M.
AU - Colantuoni, Elizabeth
AU - Howell, Benjamin
AU - Wolff, Jennifer L.
N1 - Publisher Copyright:
© 2016 American College of Emergency Physicians.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Study objective We examine factors associated with persistent frequent emergency department (ED) use during a 2-year period among Medicare beneficiaries. Methods We conducted a retrospective, claims-based analysis of fee-for-service Medicare beneficiaries, using the Chronic Condition Data Warehouse's random 20% sample files. We used multinomial logistic regression models to compare frequent ED use (defined as 4 or more ED visits per year) with infrequent use (1 to 3 visits per year), non-ED use, and death in 2010 as a function of sociodemographic, primary care, clinical characteristics, and 2009 ED use. Results Approximately 1.1% of Medicare beneficiaries were persistent frequent ED users, defined as experiencing frequent ED use in 2009 and 2010 consecutively. Of the 3.3% of Medicare beneficiaries who were frequent ED users in 2009, 34.3% were frequent ED users, 19.4% were non-ED users, 39.0% were infrequent ED users, and 7.4% died in 2010. Frequent ED use in 2009 was highly associated with frequent ED use in 2010 (relative risk ratio 35.2; 95% confidence interval 34.5 to 35.8). Younger age, Medicaid status, and mental illness were also strong predictors of frequent ED use. The probability of frequent ED use in 2010 was 3.4% for the total sample, but was 19.4% for beneficiaries who were frequent users in 2009 and 49.0% for beneficiaries in the youngest age group who had mental illness, Medicaid, and frequent ED use in 2009. Conclusion Efforts to curtail frequent ED use in Medicare should focus on disabled, socially vulnerable beneficiaries.
AB - Study objective We examine factors associated with persistent frequent emergency department (ED) use during a 2-year period among Medicare beneficiaries. Methods We conducted a retrospective, claims-based analysis of fee-for-service Medicare beneficiaries, using the Chronic Condition Data Warehouse's random 20% sample files. We used multinomial logistic regression models to compare frequent ED use (defined as 4 or more ED visits per year) with infrequent use (1 to 3 visits per year), non-ED use, and death in 2010 as a function of sociodemographic, primary care, clinical characteristics, and 2009 ED use. Results Approximately 1.1% of Medicare beneficiaries were persistent frequent ED users, defined as experiencing frequent ED use in 2009 and 2010 consecutively. Of the 3.3% of Medicare beneficiaries who were frequent ED users in 2009, 34.3% were frequent ED users, 19.4% were non-ED users, 39.0% were infrequent ED users, and 7.4% died in 2010. Frequent ED use in 2009 was highly associated with frequent ED use in 2010 (relative risk ratio 35.2; 95% confidence interval 34.5 to 35.8). Younger age, Medicaid status, and mental illness were also strong predictors of frequent ED use. The probability of frequent ED use in 2010 was 3.4% for the total sample, but was 19.4% for beneficiaries who were frequent users in 2009 and 49.0% for beneficiaries in the youngest age group who had mental illness, Medicaid, and frequent ED use in 2009. Conclusion Efforts to curtail frequent ED use in Medicare should focus on disabled, socially vulnerable beneficiaries.
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U2 - 10.1016/j.annemergmed.2016.01.033
DO - 10.1016/j.annemergmed.2016.01.033
M3 - Article
C2 - 26947801
AN - SCOPUS:84959284688
SN - 0196-0644
VL - 67
SP - 721
EP - 729
JO - Annals of emergency medicine
JF - Annals of emergency medicine
IS - 6
ER -