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Am J Manag Care. 2013 Dec 1;19(12):e391-9.

Characteristics of low-severity emergency department use among CHIP enrollees.

Author information

1
1665 University Blvd, Rm 330, Birmingham, AL 35294. E-mail: jblackburn@uab.edu.

Abstract

OBJECTIVES:

To describe patient characteristics among those utilizing the emergency department (ED) for low-severity conditions (ie, conditions potentially treatable or manageable in a primary care setting).

STUDY DESIGN:

A pooled cross-sectional study of administrative claims for ED visits among enrollees in Alabama's Children's Health Insurance Program (CHIP), ALL Kids, from January 1, 1999, through December 31, 2010.

METHODS:

Severity of visit was categorized based on primary diagnosis code using an established claims-based algorithm. Logistic regression was used to identify patient characteristics that predicted low-severity ED visits relative to high-severity visits.

RESULTS:

Of a total of 141,709 qualifying ED visits, 97,961 (69%) were classified as low severity, 33,941 (24%) as intermediate severity, and 9807 (7%) as high severity. Based on absolute risk differences, we found that among children utilizing the ED, low-severity visits were more likely than high-severity visits among children who were noncompliant with recommended well-child care (1.2 percentage points, 95% confidence interval [CI], 0.4-1.9); children who were nonurban residents (urban vs isolated: 1.6 percentage points, 95% CI, 1.0-2.2; urban vs small rural: 1.1 percentage points, 95% CI, 0.5-1.7); children without chronic disease (10.3 percentage points, 95% CI, 9.9-10.7) and children whose ED visits were on Sunday versus weekdays (0.9 percentage point, 95% CI, 0.6-1.3), and on Saturday versus weekdays (1.2 percentage points; 95% CI, 0.8-1.6).

CONCLUSIONS:

Our results suggest that improving access to primary care on weekends and in rural areas are potential ways to improve the efficient use of ED services.

PMID:
24512087
[Indexed for MEDLINE]
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