Study objectives: The purpose of the study is to identify risk factors for emergency department (ED) utilization among patients with chronic conditions. Methods: This is a descriptive, population-based study using data from the Medical Expenditure Panel Survey 2000. Individuals aged 18 years or older and with diagnoses of chronic obstructive pulmonary disease, congestive heart failure, diabetes mellitus, or hypertension were included as having chronic conditions. Those patients were classified as ED users and non-ED users. Variables representing characteristics such as demographics, socioeconomic status, health care utilization, and number of chronic conditions were used in the analysis. STATA software was used for Taylor-series approach to estimate SE for weighted survey estimates. Multivariable analysis (stratification) and regression model were used to compare the 2 groups and to assess the factors associated with visits to the ED. Confidence intervals were calculated in each analysis. Results: Of 25,095 cases reviewed, 3,997 (16%) were identified as having at least 1 of the 4 chronic conditions, and 18% of those were ED users. There were no statistically significant differences between ED users and non-ED users in variables such as age and insurance status. When the regression model was analyzed, statistically significant factors associated with ED users were being female, nonwhite, or unmarried; lacking prescription medical insurance; having a higher incidence of outpatient physician visits; and having a higher incidence of prescriptions drug refills (P<.01). Conclusion: Individuals who have chronic conditions and are poor, lack prescription insurance, are female, are nonwhite, have less than a college education, or have a poor perception of their mental and physical health status are more likely to use the ED for care. Study objectives: The purpose of the study is to identify risk factors for emergency department (ED) utilization among patients with chronic conditions. Methods: This is a descriptive, population-based study using data from the Medical Expenditure Panel Survey 2000. Individuals aged 18 years or older and with diagnoses of chronic obstructive pulmonary disease, congestive heart failure, diabetes mellitus, or hypertension were included as having chronic conditions. Those patients were classified as ED users and non-ED users. Variables representing characteristics such as demographics, socioeconomic status, health care utilization, and number of chronic conditions were used in the analysis. STATA software was used for Taylor-series approach to estimate SE for weighted survey estimates. Multivariable analysis (stratification) and regression model were used to compare the 2 groups and to assess the factors associated with visits to the ED. Confidence intervals were calculated in each analysis. Results: Of 25,095 cases reviewed, 3,997 (16%) were identified as having at least 1 of the 4 chronic conditions, and 18% of those were ED users. There were no statistically significant differences between ED users and non-ED users in variables such as age and insurance status. When the regression model was analyzed, statistically significant factors associated with ED users were being female, nonwhite, or unmarried; lacking prescription medical insurance; having a higher incidence of outpatient physician visits; and having a higher incidence of prescriptions drug refills (P<.01). Conclusion: Individuals who have chronic conditions and are poor, lack prescription insurance, are female, are nonwhite, have less than a college education, or have a poor perception of their mental and physical health status are more likely to use the ED for care.
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