Skip to main content
Journal cover image

Understanding Frequent Emergency Department Use Among Primary Care Patients.

Publication ,  Journal Article
Hardy, M; Cho, A; Stavig, A; Bratcher, M; Dillard, J; Greenblatt, L; Schulman, K
Published in: Popul Health Manag
February 2018

Patients with high emergency department (ED) utilization are an important focus in population health management. This retrospective cohort study analyzed patterns of frequent ED use for 4087 patients enrolled at an academically-affiliated primary care clinic. For all ED visits (n = 4776), the chief complaints, admission rates, number of complaints per patient, and median time between return visits were assessed. Chart reviews were conducted for the 10 highest utilizers from each of the 3 leading complaints to help explain repeated ED use for the same complaints. Results showed that chief complaints for high utilizers were statistically similar to other patients. Nearly half (49.8%) of all ED visits among high utilizers were repeat visits for the same complaint. However, most high utilizers (85%) had 4 or more separate complaints. Their visits clustered temporally, with 55% occurring less than 30 days apart. Visits for psychiatric symptoms demonstrated the shortest time to repeat visit (median 17.5 days, interquartile range: 39.5). Abdominal pain, chest pain, and shortness of breath were the leading complaints and the leading sources of hospital admissions and repeat visits. Chart review revealed that these 3 chief complaints often were associated with a wide range of ongoing chronic conditions, confounded by substance abuse, anxiety, and treatment nonadherence. This study demonstrates an integrative method for examining patterns of ED use among high utilizers. It also highlights the complex nature of high utilization and the inherent difficulty in predicting and addressing the needs of high-utilizer patients.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Popul Health Manag

DOI

EISSN

1942-7905

Publication Date

February 2018

Volume

21

Issue

1

Start / End Page

24 / 31

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Primary Health Care
  • Patient Care Management
  • Patient Acceptance of Health Care
  • Middle Aged
  • Mental Disorders
  • Male
  • Humans
  • Female
  • Emergency Service, Hospital
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hardy, M., Cho, A., Stavig, A., Bratcher, M., Dillard, J., Greenblatt, L., & Schulman, K. (2018). Understanding Frequent Emergency Department Use Among Primary Care Patients. Popul Health Manag, 21(1), 24–31. https://doi.org/10.1089/pop.2017.0030
Hardy, Morgan, Alex Cho, Alissa Stavig, Marigny Bratcher, Janice Dillard, Lawrence Greenblatt, and Kevin Schulman. “Understanding Frequent Emergency Department Use Among Primary Care Patients.Popul Health Manag 21, no. 1 (February 2018): 24–31. https://doi.org/10.1089/pop.2017.0030.
Hardy M, Cho A, Stavig A, Bratcher M, Dillard J, Greenblatt L, et al. Understanding Frequent Emergency Department Use Among Primary Care Patients. Popul Health Manag. 2018 Feb;21(1):24–31.
Hardy, Morgan, et al. “Understanding Frequent Emergency Department Use Among Primary Care Patients.Popul Health Manag, vol. 21, no. 1, Feb. 2018, pp. 24–31. Pubmed, doi:10.1089/pop.2017.0030.
Hardy M, Cho A, Stavig A, Bratcher M, Dillard J, Greenblatt L, Schulman K. Understanding Frequent Emergency Department Use Among Primary Care Patients. Popul Health Manag. 2018 Feb;21(1):24–31.
Journal cover image

Published In

Popul Health Manag

DOI

EISSN

1942-7905

Publication Date

February 2018

Volume

21

Issue

1

Start / End Page

24 / 31

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Primary Health Care
  • Patient Care Management
  • Patient Acceptance of Health Care
  • Middle Aged
  • Mental Disorders
  • Male
  • Humans
  • Female
  • Emergency Service, Hospital