Psychiatric co-morbidities and substance abuse are dominant factors in Predicting Emergency Department usage rates
<p>Importance: 1% of the United States population accounts for 20% of healthcare costs. What characterizes heavy users of the Emergency Department (UED) both demographically and clinically is an area of active research.</p><p>Objective: Compare the proportion of nine common co-morb...
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Archives of Community Medicine and Public Health - Peertechz Publications,
2022-08-17.
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LEADER | 00000 am a22000003u 4500 | ||
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001 | peertech__10_17352_2455-5479_000182 | ||
042 | |a dc | ||
100 | 1 | 0 | |a Lydia Mitchell |e author |
700 | 1 | 0 | |a Emily Moseley |e author |
700 | 1 | 0 | |a Ralph O'Neil |e author |
700 | 1 | 0 | |a Lawrence M Lewis |e author |
245 | 0 | 0 | |a Psychiatric co-morbidities and substance abuse are dominant factors in Predicting Emergency Department usage rates |
260 | |b Archives of Community Medicine and Public Health - Peertechz Publications, |c 2022-08-17. | ||
520 | |a <p>Importance: 1% of the United States population accounts for 20% of healthcare costs. What characterizes heavy users of the Emergency Department (UED) both demographically and clinically is an area of active research.</p><p>Objective: Compare the proportion of nine common co-morbidities between heavy, moderate, and infrequent users then compare episodic and continuous heavy UED. </p><p>Setting: A large metropolitan healthcare system.</p><p>Participants: Heavy users were selected using a retrospective chart review of Barnes-Jewish Emergency Department records from 2010-2011. Emergency department usage for all unique patients seen in the time period specified was determined for two non-overlapping 365-day periods. Patients were stratified into 1 of 3 groups: Heavy users (> 10 visits for both periods), moderate users (5-9 visits for both periods), and infrequent users (1 visit in either the first or last period). There were 546 moderate users and 59,957 infrequent users matched 1:1 against 160 heavy users. These patients were matched for age, race, gender, and insurance. The 160 continuous heavy users were also compared to 388 patients who had > 10 visits in the first period, but not the second period, and 443 patients who had > 10 visits in the second period, but not the first. The proportion of subjects within each group was compared based on nine co-morbidities (substance abuse, mental illness, chronic pain, heart disease, lung disease, kidney disease, liver disease, cancer and stroke) using 95% confidence intervals.</p><p>Results: Infrequent users had lower rates of all co-morbidities. Moderate users had similar rates of all co-morbidities to heavy users, except slightly higher CVA rates (13.7% v 10.6%; p = 0.49), lower rates for mental illness (33.3% v 43.1%; p = 0.08) and significantly lower rates for substance abuse (17% v 35%; p < 0.001). Only substance abuse demonstrated a significant difference between episodic and continuous heavy UED (35% v 23.5%; p = 0.002). </p><p>Conclusion: Among nine common co-morbidities, only substance abuse rates were significantly higher among heavy users compared to matched moderate UED in our healthcare system. Infrequent users had lower rates of all co-morbidities. When comparing continuous and episodic heavy emergency department users, only substance abuse rates were significantly higher.</p> | ||
540 | |a Copyright © Lydia Mitchell et al. | ||
546 | |a en | ||
655 | 7 | |a Research Article |2 local | |
856 | 4 | 1 | |u https://doi.org/10.17352/2455-5479.000182 |z Connect to this object online. |