ED utilization: the effect of changing demographics from 1992 to 2000.
To explore factors contributing to increased emergency department (ED) utilization, this retrospective chart review compared ED visits for a 2-week period in both 1992 and 2000 at a rural, tertiary medical center. Total ED visits increased 455 between the periods (% increase = 28.6%), whereas county population increased 18,253 (% increase = 16.1%) (P < 0.005). Average age increased from 35.2 +/- 23.8 years to 40.1 +/- 23.6 years (95% confidence interval, difference of means, 3.34 to 6.45). Patients over 80 years increased by 83%, whereas those over 90 years increased 138%. The admission rate, increased from 21.9% to 25.6% (P < 0.005). Patients with Medicare as primary insurance increased from 17.9% to 23.6% (P < 0.005). Increased age of the population, increased acuity as shown by 4 different measurements, and limited access to primary care physicians all contributed to increased ED demand in this study.
Reeder
Timothy
T
Department of Emergency Medicine, The Brody School of Medicine at East Carolina University, Greenville, NC 27858, USA. reedert@mail.ecu.edu
Locascio
Elizabeth
E
Tucker
Jody
J
Czaplijski
Thomas
T
Benson
Nicholas
N
Meggs
William
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019456:Health Transition; D006746:Hospital Bed Capacity, 500 and over; D006780:Hospitals, Rural; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008499:Medical Records; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012423:Rural Health; D014600:Utilization Review