Article Figures & Data
Tables
Characteristics No ED Visit* At Least 1 Nonemergent ED Visit† P Value Predisposing characteristics Age, years <.001 8–44 42.1 53.1 45–64 39.2 30.2 ≥65 18.8 16.7 Sex <.001 Female 55.5 66.4 Race <.001 White 82.6 74.4 Black 10.9 19.9 Other 6.6 5.7 Hispanic ethnicity .061 Yes 11.0 12.6 No 89.0 87.4 Education <.001 No degree 12.5 18.2 GED/high school 49.7 57.3 Bachelor's degree or more 37.9 24.5 Employment status <.001 Employed 68.8 58.0 Not employed 31.3 42.0 Marital status <.001 Married 62.0 48.5 Widowed 6.3 7.4 Divorced 10.8 13.6 Separated 1.7 3.9 Never married 19.3 26.6 Able to speak English 96.9 96.6 .558 More likely to take risks .031 Disagree strongly 43.7 45.6 Disagree somewhat 22.8 19.1 Uncertain 14.0 15.9 Agree somewhat 15.5 14.5 Agree strongly 4.0 4.8 Can overcome illness without medical help .001 Disagree strongly 48.4 54.1 Disagree somewhat 22.5 21.2 Uncertain 9.7 9.3 Agree somewhat 16.5 12.0 Agree strongly 2.8 3.4 Enabling resources Income (% of poverty level) <.001 <100 (poor) 8.5 21.3 100–199 (low income) 14.8 22.8 200–399 (middle income) 30.6 30.3 ≥400 (high income) 46.1 25.6 Health insurance <.001 Private 75.3 59.0 Public 16.1 29.5 Uninsured 8.6 11.5 Region .054 Northeast 20.1 16.4 Midwest 22.6 25.2 South 35.2 37.4 West 22.1 21.1 MSA .026 Urban 82.5 79.2 Rural 17.5 20.9 Need factors Health status <.001 Excellent 22.8 11.9 Very good 35.6 22.6 Good 28.9 34.8 Fair 10.0 19.2 Poor 2.7 11.5 Mental health <.001 Excellent 35.5 27.0 Very good 32.7 23.5 Good 25.1 32.4 Fair 5.6 13.1 Poor 1.2 4.0 Hypertension 36.3 41.7 .005 Coronary heart disease 6.0 8.6 .002 Angina 3.0 4.4 .024 Myocardial infarction 3.9 6.0 .001 Other heart disease 10.8 13.7 .010 Stroke 3.4 7.5 <.001 Emphysema 2.4 5.1 <.001 High cholesterol 36.6 35.8 .662 Diabetes 10.7 14.6 <.001 Arthritis 28.7 35.2 <.001 Asthma 9.6 18.0 <.001 - Table 2. Respondents' Perceptions of Quality of Care and Access to Usual Source of Care (USC) by Emergency Department (ED) Visit Status
No ED Visit* At Least 1 Nonemergent ED Visit† P Value Patient-provider communication USC asks about other treatments 82.9 84.3 .280 USC shows respect for treatments .217 Always 66.6 64.7 Not always 33.4 35.3 USC asks person to help decide .007 Always 62.2 58.2 Not always 37.8 41.8 USC explains options to person 94.9 93.0 .007 USC speaks language or provides interpreter services 99.5 99.3 .483 Access Transportation to USC <.001 Drives 87.3 77.4 Is driven 7.5 14.2 Public transportation 3.0 6.0 Walks or uses other mode 2.3 2.5 Time to USC, minutes .003 <15 50.8 48.8 15–30 39.1 37.8 31–60 8.4 10.0 >60 1.8 3.4 USC has office hours on nights and weekends 38.5 35.1 .052 Difficulty getting to USC <.001 Very difficult 0.7 2.1 Somewhat difficult 3.8 8.5 Not too difficult 17.1 21.5 Not at all difficult 78.4 68.0 Difficulty in contacting USC by phone <.001 Very difficult 4.4 6.8 Somewhat difficult 10.8 13.8 Not too difficult 27.2 28.6 Not at all difficult 57.6 50.8 Difficulty in contacting USC after hours <.001 Very difficult 12.2 20.0 Somewhat difficult 11.5 13.3 Not too difficult 23.9 24.1 Not at all difficult 28.3 23.3 Unsure 24.1 19.3 - Table 3. Estimation Results of the Two-Part Model of the Frequency of Nonemergent Emergency Department (ED) Visits
Binary Hurdle Model (Logit) Zero-Truncated Negative Binomial Model Coefficient t Value Coefficient t Value Constant −2.382* −2.81 −17.329* −5.52 Predisposing characteristics Age, years 45–64 −0.651* −7.76 −0.490* −2.15 ≥65 −0.738* −5.39 −0.717 −1.93 Female sex 0.339* 4.51 0.244 1.23 Race Black 0.386* 4.06 −0.701* −3.33 Other −0.123 −0.79 −0.853* −2.51 Hispanic ethnicity −0.010 −0.10 0.532* 2.00 Education GED/high school 0.155 1.47 0.490* 2.08 Bachelor's degree or more −0.078 −0.57 0.825* 2.70 Employed −0.043 −0.44 0.187 0.93 Marital status Widowed 0.035 0.20 0.479 1.37 Divorced 0.059 0.51 −0.215 −0.73 Separated 0.313* 1.98 0.248 0.56 Never married 0.126 1.29 0.173 0.79 Able to speak English 0.416* 2.54 0.926 1.67 More likely to take risks 0.061 0.61 0.206 0.94 Can overcome illness without medical help −0.167 −1.71 −0.264 −1.15 Enabling resources Income (% of poverty level) <100 (poor) 0.716* 5.15 0.177 0.59 100–199 (low income) 0.495* 3.98 0.098 0.41 200–399 (middle income) 0.279* 2.30 0.321 1.23 Health insurance Public 0.177 1.60 0.294 1.36 Uninsured 0.064 0.54 0.503 1.92 Region Midwest 0.285* 2.23 0.028 0.10 South 0.088 0.67 −0.188 −0.71 West 0.148 1.11 −0.033 −0.11 Urban MSA −0.090 −0.86 0.295 1.34 Need factors Health status Very good 0.280* 2.07 −0.350 −0.95 Good 0.777* 5.57 0.120 0.37 Fair 1.047* 6.31 0.713 1.87 Poor 1.689* 8.26 0.857* 1.96 Mental health Very good −0.216* −2.09 0.234 0.88 Good −0.086 −0.74 0.220 1.00 Fair 0.045 0.32 −0.185 −0.63 Poor 0.045 0.22 0.412 0.97 Hypertension −0.105 −1.10 −0.233 −0.91 Coronary heart disease −0.103 −0.70 −0.104 −0.25 Angina 0.119 0.52 1.044* 2.02 Myocardial infarction −0.132 −0.73 0.224 0.49 Other heart disease −0.011 −0.09 −0.647 −1.94 Stroke −0.468* −2.85 −0.539 −1.46 Emphysema −0.041 −0.22 −0.211 −0.66 High cholesterol 0.054 0.55 0.724* 3.36 Diabetes −0.025 −0.21 0.356 1.39 Arthritis −0.066 −0.73 0.126 0.67 Asthma −0.335* −3.42 −0.310 −1.52 Patient-provider communication USC asks about other treatments 0.164 1.79 −0.152 −0.76 USC shows respect for treatments 0.062 0.69 0.161 0.78 USC asks person to help decide −0.075 −0.83 0.179 0.90 USC explains options to person −0.154 −1.09 −0.316 −0.90 USC speaks language or provides interpreter services −0.344 −0.83 −2.063* −2.28 Access Transportation to USC Is driven 0.047 0.39 0.209 0.87 Public transportation 0.155 0.90 0.065 0.20 Walks or other −0.161 -0.66 0.715 1.47 Time to USC, minutes 15–30 −.077 −0.99 −0.211 −1.13 31–60 −0.044 −0.33 0.418 1.20 >60 0.262 1.13 0.974* 2.43 USC has office hours on nights and weekends 0.051 0.62 0.324* 2.02 Difficulty getting to USC 0.323* 2.45 −0.144 −0.53 Difficulty in contacting USC by phone 0.144 1.50 −0.297 −1.18 Difficulty in contacting USC after hours 0.180* 2.29 0.387* 1.96 ↵* P < .05.
MSA, metropolitan statistical area; USC, usual source of care.
- Table 4. Sensitivity Analysis of Results of the Two-Part Model of the Frequency of Nonemergent Emergency Department (ED) Visits, Including Individuals With Emergent ED Visits
Binary Hurdle Model (Logit) Zero-Truncated Negative Binomial Model Coefficient t Value Coefficient t Value Constant −3.144* −3.80 −17.107* −7.83 Predisposing characteristics Age, years 45–64 −0.620* −7.53 −0.513* −2.28 ≥65 −0.686* −5.27 −0.749* −2.02 Female sex 0.307* 4.26 0.209 1.09 Race Black 0.362* 3.82 −0.728* −3.52 Other −0.110 −0.78 −0.900* −2.68 Hispanic ethnicity −0.013 −0.13 0.530* 2.03 Education High school 0.155 1.53 0.519* 2.29 Bachelor's degree or more −0.059 −0.45 0.850* 2.89 Employed −0.021 −0.22 0.159 0.80 Marital status Widowed 0.001 0.01 0.512 1.52 Divorced 0.035 0.30 −0.182 −0.62 Separated 0.304* 2.00 0.248 0.55 Never married 0.109 1.11 0.203 0.93 Able to speak English 0.289 1.76 0.788 1.55 More likely to take risks 0.026 0.26 0.161 0.73 Can overcome illness without medical help −0.119 −1.23 −0.293 −1.29 Enabling resources Income (% of poverty level) <100 (poor) 0.652* 4.77 0.170 0.59 100–199 (low income) 0.468* 3.78 0.078 0.33 200–399 (middle income) 0.272* 2.24 0.295 1.14 Health insurance Public 0.170 1.59 0.297 1.40 Uninsured 0.101 0.85 0.481 1.85 Region Midwest 0.341* 2.69 0.014 0.05 South 0.158 1.24 −0.174 −0.66 West 0.202 1.51 −0.027 −0.09 Urban MSA −0.105 −1.03 0.280 1.32 Need factors Health status Very good 0.270* 1.99 −0.406 −1.11 Good 0.738* 5.35 0.061 0.19 Fair 0.978* 5.97 0.593 1.56 Poor 1.502* 7.45 0.725 1.68 Mental health Very good −0.201* −1.96 0.255 0.96 Good −0.050 −0.43 0.243 1.12 Fair 0.030 0.22 −0.121 −0.42 Poor −0.060 −0.30 0.447 1.08 Hypertension −0.084 −0.88 −0.247 −0.95 Coronary heart disease −0.096 −0.66 −0.081 −0.20 Angina 0.207 0.94 1.017* 1.99 Myocardial infarction −0.024 −0.13 0.174 0.38 Other heart disease 0.023 0.20 −0.632 −1.90 Stroke −0.332* −2.10 −0.507 −1.41 Emphysema −0.117 −0.67 −0.222 −0.72 High cholesterol 0.061 0.65 0.705* 3.40 Diabetes −0.014 −0.12 0.323 1.27 Arthritis −0.036 −0.41 0.132 0.71 Asthma −0.283* −2.92 −0.324 −1.60 Patient-provider communication USC asks about other treatments 0.145 1.60 −0.119 −0.58 USC shows respect for treatments 0.040 0.46 0.127 0.64 USC asks person to help decide −0.060 −0.67 0.205 1.08 USC explains options to person −0.146 −1.08 −0.332 −0.94 USC speaks language or provides interpreter services −0.350 −0.88 −2.130* −2.62 Access Transportation to USC Is driven −0.016 −0.14 0.228 0.96 Public transportation 0.190 1.11 0.081 0.25 Walks or other −0.183 −0.76 0.728 1.50 Time to USC 15 to 30 minutes −0.073 −0.97 −0.196 −1.05 31 to 60 minutes −0.023 −0.18 0.404 1.16 >60 minutes 0.296 1.29 1.014* 2.53 USC has office hours on nights and weekends 0.045 0.56 0.307 1.91 Difficulty getting to USC 0.265* 2.03 −0.164 −0.61 Difficulty in contacting USC by phone 0.113 1.22 −0.313 −1.24 Difficulty in contacting USC after hours 0.163* 2.04 0.390* 2.01 ↵* P < .05.
MSA, metropolitan statistical area; USC, usual source of care.
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