title: Analysis of chronic emergency department use.
abstract: This retrospective emergency department (ED) chart review study examined the relationship between acuity level and the type of insurance in a patient population who used the ED on a chronic basis (seven or more times in the calendar year 1996). Of 1,185 patients seen in the ED in 1996, 122 had between 7 and 29 visits. In the study population: 62.5% of their visits were classified as nonurgent; 42.6% of the nonurgent visits were made by those with insurance; the highest frequency of visits took place between 8:00 am and 4:00 pm when most alternative nonemergency facilities are open. Some of the factors seen as influencing overuse of the ED include: the fact that some chronic use appeared to be associated with psychiatric conditions including substance abuse and patients with recurrent chest pain; and patient's perceptions that access to lab and X-ray facilities are readily available within the ED.
authors.affiliation: Emergency Department Nurse, North Austin Medical Center, TX, USA.
authors.forename: T K
authors.initials: TK
authors.lastname: Bond
authors.forename: S
authors.initials: S
authors.lastname: Stearns
authors.forename: M
authors.initials: M
authors.lastname: Peters
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002908:Chronic Disease; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014768:Virginia