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Brief ReportBrief Report

Emergency Department High Utilizers among Family Medicine Patients

Stacey Kirkpatrick, Denny Fe G. Agana, Kim Lynch and Peter J. Carek
The Journal of the American Board of Family Medicine March 2019, 32 (2) 264-268; DOI: https://doi.org/10.3122/jabfm.2019.02.180184
Stacey Kirkpatrick
From University of Florida College of Medicine, Gainesville, FL (SK); Department of Community Health and Family Medicine ((DFGA, KL, PC), Department of Epidemiology (DFGA), University of Florida, Gainesville.
BA
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Denny Fe G. Agana
From University of Florida College of Medicine, Gainesville, FL (SK); Department of Community Health and Family Medicine ((DFGA, KL, PC), Department of Epidemiology (DFGA), University of Florida, Gainesville.
MPH, PhD
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Kim Lynch
From University of Florida College of Medicine, Gainesville, FL (SK); Department of Community Health and Family Medicine ((DFGA, KL, PC), Department of Epidemiology (DFGA), University of Florida, Gainesville.
MSHI
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Peter J. Carek
From University of Florida College of Medicine, Gainesville, FL (SK); Department of Community Health and Family Medicine ((DFGA, KL, PC), Department of Epidemiology (DFGA), University of Florida, Gainesville.
MD, MS
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    Figure 1.

    Venn diagram of emergency department (ED) high utilizers by year, 2015 to 2017.

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    Table 1.

    Demographic and Medical Characteristics of Emergency Department High Utilizers from 2015 to 2017 Compared to General Family Medicine Outpatient Population of Low Utilizers

    Demographic or CharacteristicLow <6/yrHigh ≥6/yrP value
    Patients, n18,638943
    Age, mean (±SD)43.7 (±21.2)46 (±19.4)<.005*
    Sex, n (%)
        Male7,154 (38.4)313 (33.2).002
        Female11,484 (61.6)630 (66.8)
    Race, n (%)
        White10,215 (54.8)402 (42.6)<.001**
        Black7,121 (38.2)509 (54.0)
        Other1,141 (6.1)32 (3.4)
    Ethnicity, n (%)
        Hispanic828 (4.4)35 (3.7).11
        Non-Hispanic17,806 (95.5)908 (96.3)
    Gainesville location, n (%)
        East5,808 (31.1)409 (43.3)<.001**
        West6,030 (32.2)250 (26.5)
        Other6,800 (36.5)284 (30.1)
    Marital status, n (%)
        Single9,594 (51.5)507 (53.8)<.001**
        Married6,371 (34.1)229 (24.2)
        Divorced1,310 (7.0)118 (12.5)
        Other1,154 (6.2)89 (9.4)
    Insurance status, n (%)
        Commercial/third party8,342 (44.8)215 (22.8)<.001**
        Medicare4,396 (23.6)296 (31.4)
        Medicaid4,466 (24.0)382 (40.5)
        Other1,431 (44.8)50 (22.8)
    Chronic pain, n (%)
        Yes,1,110 (0.06)155 (0.16)<.001**
        No17,528 (0.94)788 (0.84)
    Substance use, n (%)
        Yes1,648 (0.09)210 (0.22)<.001**
        No16,990 (0.91)733 (0.78)
    Psychiatric condition, n (%)
        Yes7,688 (0.41)613 (0.65)<.001**
        No10,950 (0.59)330 (0.35)
    Medications, mean (±SE)7.4 (±0.06)25.45 (±0.66)<.001**
    • ↵* P < .05,

    • ↵** P < .001.

    • SD, standard deviation; SE, standard error.

    • View popup
    Table 2.

    Demographic and Medical Characteristics of Emergency Department High Utilizers from 2015 to 2017

    Demographic or Characteristic201520162017P value
    2015 vs 20162016 vs 20172015 vs 2017
    Patients, n432428427
    Age, mean (±SD)46.2 (±18.5)45.8 (±18.2)46.1 (±18.8).78.84.94
    Sex, n (%)
        Male150 (34.7)142 (33.2)134 (31.4).66.61.31
        Female282 (65.30)286 (66.8)293 (68.6)
    Race, n (%)
        White181 (41.9)185 (43.2)165 (38.6).82.38.59
        African American238 (55.1)228 (53.3)247 (57.8)
        Other13 (3.0)15 (3.5)15 (3.5)
    Ethnicity, n (%)
        Hispanic13 (3.0)13 (3.0)18 (4.2)1.37.37
        Non-Hispanic419 (97.0)415 (97.0)409 (95.8)
    Home location, n (%)
        East209 (48.4)187 (43.7)167 (39.1).36.13.014*
        West94 (21.8)97 (22.7)122 (28.6)
        Other129 (29.9)144 (33.6)138 (32.3)
    Marital status, n (%)
        Single231 (53.5)227 (53.0)227 (53.2).68.96.76
        Married95 (22.0)107 (25.0)105 (24.6)
        Divorced62 (14.4)53 (12.4)57 (13.3)
        Other44 (10.2)41 (9.6)38 (8.9)
    Insurance status, n (%)
        Commercial/third party85 (19.7)86 (20.0)85 (19.9).87.6.39
        Medicare144 (33.3)133 (31.1)140 (32.8)
        Medicaid178 (41.2)186 (43.5)184 (43.1)
        Other25 (5.8)23 (5.4)18 (4.2)
    Chronic pain, n (%)
        Yes58 (13.4)75 (17.5)64 (15.0).11.35.56
        No374 (86.6)353 (82.5)363 (85.0)
    Substance use, n (%)
        Yes91 (21.0)92 (21.5)90 (21.1).93.931
        No341 (78.9)336 (78.5)337 (78.9)
    Psychiatric condition
        Yes258 (59.7)258 (60.3)277 (64.9).18.89.12
        No174 (40.3)170 (39.7)150 (35.1)
    Medications, mean (±SD)48.8 (±33.5)51.0 (±34.8)50.9 (±34.3).35.97.36
    • ↵* P < .05.

    • SD, standard deviation.

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The Journal of the American Board of Family     Medicine: 32 (2)
The Journal of the American Board of Family Medicine
Vol. 32, Issue 2
March-April 2019
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Emergency Department High Utilizers among Family Medicine Patients
Stacey Kirkpatrick, Denny Fe G. Agana, Kim Lynch, Peter J. Carek
The Journal of the American Board of Family Medicine Mar 2019, 32 (2) 264-268; DOI: 10.3122/jabfm.2019.02.180184

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Emergency Department High Utilizers among Family Medicine Patients
Stacey Kirkpatrick, Denny Fe G. Agana, Kim Lynch, Peter J. Carek
The Journal of the American Board of Family Medicine Mar 2019, 32 (2) 264-268; DOI: 10.3122/jabfm.2019.02.180184
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