title: High users of VA emergency room facilities: are outpatients abusing the system or is the system abusing them?
abstract: A phenomenon well known to emergency room personnel is the high use of ER facilities by a small number of patients. In this study of 335 patients followed in outpatient specialty clinics at a university-affiliated VA medical center, 23% of the patients accounted for 73% of the ER visits. Although some patients may be abusing the system, the problem is difficult to correct because of congressional legislation that deters the VA from providing primary care. Thus, a small subset of patients with chronic medical problems who live close to the hospital are likely to continue to consume a disproportionate amount of ER resources.
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003237:Connecticut; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006296:Health Services; D006300:Health Services Misuse; D006746:Hospital Bed Capacity, 500 and over; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged