RT Journal Article
SR Electronic
T1 Nonemergent Emergency Department Use Among Patients With a Usual Source of Care
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 680
OP 691
DO 10.3122/jabfm.2013.06.120327
VO 26
IS 6
A1 Villani, Jennifer
A1 Mortensen, Karoline
YR 2013
UL http://www.jabfm.org/content/26/6/680.abstract
AB Purpose: Emergency department (ED) use for nonemergent conditions is associated with discontinuity of care at a greater cost. The objective of this study was to determine whether the quality of patient-provider communication and access to one's usual source of care (USC) were associated with greater nonemergent ED use. Methods: A hurdle model was employed using data from the 2007 to 2009 Medical Expenditure Panel Survey. First, a multivariate logistic regression model was used to identify factors associated with the likelihood of a nonemergent ED visit. Given that one occurrence exists, a second negative binomial model was used to establish whether patient-provider communication or access are related to the frequency of nonemergent ED use. Results: One element of communication, patient-provider language concordance, is associated with fewer nonemergent ED visits (P < .05). Several aspects of access are related to reduced ED use for nonemergent purposes. Patients whose USC is available after hours and those who travel less than an hour to get to their USC use the ED less for nonemergent care (P ≤ .05). Conclusions: Enhancing primary care by expanding interpreter services and access to care after hours may reduce the demand for nonemergent ED services.