title: Factors associated with emergency department utilization by urban lesbian, gay, and bisexual individuals.
abstract: There are no published studies to date on emergency department (ED) utilization by the lesbian, gay, and bisexual (LGB) community despite documented lack of access to health care for this community. This study explored the frequency of ED visits and sociodemographic and health-related factors associated with ED utilization among a convenience sample of LGB individuals. A sample of 360 LGB individuals was interviewed to assess socio-demographics, sexual practices, mental health, drug use, chronic disease history, and frequency of emergency department use. Emergency department utilization was categorized as 0, 1, or > or =2 visits. Bivariate statistics were applied to assess the association of various factors with emergency department utilization. Patient characteristics were as follows: age, 29.0; male, 53.1 percent; Hispanic, 57.8 percent; Black, 37.2 percent; and reported less than a college degree, 79.4 percent. Most (77.7 percent) had a primary care doctor and (86.3 percent) were comfortable discussing LGB-related health issues with their provider. Over 12 months, 25.3 percent had 1 ED visit and 16.4 percent had > or =2 ED visits. One or more emergency department visits was significantly associated with lower age, lower education, lower income, recent psychological distress, recent mental health counseling or medications, desired mental health treatment, abuse by partner, cigarette use, marijuana use, and asthma (p < 0.05). Despite reported access to primary care, our LGB sample exhibited a higher proportion of single and > or =2 ED visits than comparable populations. Mental health and cigarette use were associated with emergency department utilization and deserve further exploration for reducing emergency department visitation by and improving emergency department care for LGB individuals.
authors.affiliation: john.sanchez@nbhn.net
authors.forename: John Paul
authors.initials: JP
authors.lastname: Sánchez
authors.forename: Susan
authors.initials: S
authors.lastname: Hailpern
authors.forename: Carla
authors.initials: C
authors.lastname: Lowe
authors.forename: Yvette
authors.initials: Y
authors.lastname: Calderon
mesh_terms: D000328:Adult; D001727:Bisexuality; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D018452:Homosexuality, Female; D018451:Homosexuality, Male; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D020380:Needs Assessment; D009519:New York City