Nonurgent emergency department visits: the effect of having a regular doctor. 1998

L A Petersen, and H R Burstin, and A C O'Neil, and E J Orav, and T A Brennan
Health Services Research and Development, Brockton/West Roxbury VA Medical Center, MA, USA.

OBJECTIVE The authors assess the association between having a regular doctor and presentation for nonurgent versus urgent emergency department visits while controlling for potential confounders such as sociodemographics, health status, and comorbidity. METHODS A cross-sectional study was conducted in emergency departments of five urban teaching hospitals in the northeast. Adult patients presenting with chest pain, abdominal pain, or asthma (n = 1696; 88% of eligible) were studied. Patients completed a survey on presentation, reporting sociodemographics, health status, comorbid diseases, and relationship with a regular doctor. Urgency on presentation was assessed by chart review using explicit criteria. RESULTS Of the 1,696 study participants, 852 (50%) presented with nonurgent complaints. In logistic regression analyses, absence of a relationship with a regular physician was an independent correlate of presentation for a nonurgent emergency department visit (odds ratio 1.6; 95% confidence interval 1.2, 2.2) when controlling for age, gender, marital status, health status, and comorbid diseases. Race, lack of insurance, and education were not associated with nonurgent use. CONCLUSIONS Absence of a relationship with a regular doctor was correlated with use of the emergency department for selected nonurgent conditions when controlling for important potential confounders. Our study suggests that maintaining a relationship with a regular physician may reduce nonurgent use of the emergency department regardless of insurance status or health status.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009511 New England The geographic area of New England in general and when the specific state or states are not indicated. States usually included in this region are Maine, New Hampshire, Vermont, Massachusetts, Connecticut, and Rhode Island. Northeastern United States
D010821 Physicians, Family Those physicians who have completed the education requirements specified by the American Academy of Family Physicians. Family Physician,Family Physicians,Physician, Family
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D004630 Emergencies Situations or conditions requiring immediate intervention to avoid serious adverse results. Emergency
D004636 Emergency Service, Hospital Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient. Emergency Outpatient Unit,Emergency Services Utilization,Hospital Emergency Room,Hospital Emergency Service,Hospital Emergency Services Utilization,Accident and Emergency Department,Emergency Departments,Emergency Hospital Service,Emergency Room,Emergency Units,Emergency Ward,Hospital Service Emergency,Service, Hospital Emergency,Department, Emergency,Departments, Emergency,Emergencies, Hospital Service,Emergency Department,Emergency Hospital Services,Emergency Outpatient Units,Emergency Room, Hospital,Emergency Rooms,Emergency Rooms, Hospital,Emergency Services, Hospital,Emergency Unit,Emergency Wards,Emergency, Hospital Service,Hospital Emergency Rooms,Hospital Emergency Services,Hospital Service Emergencies,Hospital Service, Emergency,Hospital Services, Emergency,Outpatient Unit, Emergency,Outpatient Units, Emergency,Room, Emergency,Room, Hospital Emergency,Rooms, Emergency,Rooms, Hospital Emergency,Service Emergencies, Hospital,Service Emergency, Hospital,Service, Emergency Hospital,Services Utilization, Emergency,Services Utilizations, Emergency,Services, Emergency Hospital,Services, Hospital Emergency,Unit, Emergency,Unit, Emergency Outpatient,Units, Emergency,Units, Emergency Outpatient,Utilization, Emergency Services,Ward, Emergency,Wards, Emergency
D005260 Female Females
D006300 Health Services Misuse Excessive, under or unnecessary utilization of health services by patients or physicians. Abuse of Health Services,Misuse of Health Services,Health Services Underuse,Health Services Underutilization,Misuse, Health Services,Underuse, Health Services,Health Services Abuse,Health Services Abuses,Health Services Misuses,Health Services Underuses,Health Services Underutilizations,Misuses, Health Services,Underuses, Health Services,Underutilization, Health Services,Underutilizations, Health Services
D006784 Hospitals, Teaching Hospitals engaged in educational and research programs, as well as providing medical care to the patients. Hospital, Teaching,Teaching Hospital,Teaching Hospitals

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