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Int J Public Health. 2018 Apr;63(3):397-407. doi: 10.1007/s00038-017-1073-3. Epub 2018 Jan 13.

Is the use of emergency departments socially patterned?

Author information

1
Department of Epidemiology, Health Economics and Public Health, Toulouse University Hospital, 37, Allées Jules Guesde, 31000, Toulouse, France. ln.colineaux@gmail.com.
2
LEASP UMR1027, INSERM-Université Toulouse III, 31000, Toulouse, France. ln.colineaux@gmail.com.
3
Regional Observatory of Emergency Medicine in the Midi-Pyrénées (ORU-MiP), 31000, Toulouse, France.
4
Emergency Department, Toulouse University Hospital, 31000, Toulouse, France.
5
Department of Epidemiology, Health Economics and Public Health, Toulouse University Hospital, 37, Allées Jules Guesde, 31000, Toulouse, France.
6
LEASP UMR1027, INSERM-Université Toulouse III, 31000, Toulouse, France.
7
Department of Clinical Pharmacology, Toulouse University Hospital, 31000, Toulouse, France.

Abstract

OBJECTIVES:

To analyse the association between patients' socioeconomic position (SEP) and the use of emergency departments (EDs).

METHODS:

This population-based study included all visits to ED in 2012 by inhabitants of the French Midi-Pyrénées region, recorded by the Regional Emergency Departments Observatory. We compared ED visit rates and the proportion of non-severe visits according to the patients' SEP as assessed by the European Deprivation Index.

RESULTS:

We analysed 496,388 visits. The annual ED visit rate increased with deprivation level: 165.9 [95% CI (164.8-166.9)] visits per 1000 inhabitants among the most advantaged group, compared to 321.9 [95% CI (320.3-323.5)] per 1000 among the most disadvantaged. However, the proportion of non-severe visits was about 14% of the visits, and this proportion did not differ according to SEP.

CONCLUSIONS:

Although the study shows a difference of ED visit rates, the probability of a visit being non-severe is not meaningfully different according to SEP. This supports the assumption that ED visit rate variations according to SEP are mainly explained by SEP-related differences in health states rather than SEP-related differences in health behaviours.

KEYWORDS:

Administrative database; Emergency department; Primary access to care; Social inequalities in health

PMID:
29332173
DOI:
10.1007/s00038-017-1073-3
[Indexed for MEDLINE]

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