Abstract
This paper estimates the influence of inadequate access to healthcare services on the rate of Emergency Room (ER) hospital visits in Australia. We take micro-data on different types of healthcare shortfalls from the 2012 Australian Survey of Disability, Aging and Carers, and employ Propensity Score Matching (PSM) techniques to identify their effects on ER visits. We find that shortfalls in access to various medical services increases ER visits for individuals with mental and physical conditions by about the same degree. Conversely, inadequate community care services significantly predict ER visits for individuals with physical conditions, but not for persons with mental conditions. The lack of predictive power for inadequate community care for persons with mental health problems is surprising, as “acopia” is thought to be a significant driver of crises that require emergency treatment. We discuss some of the mechanisms that may underpin this finding and address the policy implications of our results. Lastly a number of robustness checks and diagnostics tests are presented which confirm that our modelling assumptions are not violated and that our results are insensitive to the choice of matching algorithms.
Highlights
Many hospitals in developed countries are experiencing increasing pressure due to rising numbers of patient presentations and Emergency Room (ER) admissions [1]
Compounding the pressure that these factors place on ER admission rates is inadequate access to health care services in the community, which can lead undertreated health conditions to escalate to critical levels [3]
This is a large, nationally representative micro-data set compiled by the Australian Bureau of Statistics that records observations on a wide variety of questions related to various aspects of health and social behaviour
Summary
Many hospitals in developed countries are experiencing increasing pressure due to rising numbers of patient presentations and Emergency Room (ER) admissions [1]. Compounding the pressure that these factors place on ER admission rates is inadequate access to health care services in the community, which can lead undertreated health conditions to escalate to critical levels [3]. A major modifiable factor linked to the use of ER services is the absence of primary care. Ingram [18] shows that the actual or perceived unavailability of the physician is an important factor in the use of hospital emergency facilities. Patients with non-urgent complaints generally reside within close proximity of the hospital providing evidence that the emergency facilities may act as an “off-hours” physician surrogate [18]. Studies by Kravet et al [9], 2008) and Wright et al [16] find a higher primary care physician ratio in an area associated with a statistically significant decrease in ER visits
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