Medical emergency department utilization patterns among uninsured patients with psychiatric disorders.
OBJECTIVE
This study examined medical emergency department utilization for patterns among uninsured patients with psychiatric disorders.


METHODS
Billing records of 15,672 uninsured adult patients treated in the emergency department of an academic medical center in southeast Texas over a 12-month period were analyzed for information on demographic characteristics, diagnosis, number of emergency department visits, and hospitalization.


RESULTS
Overall, 11.8% of the population was diagnosed as having at least one psychiatric disorder during an emergency department visit. Patients with psychiatric disorders had an increased risk of having multiple emergency department visits and hospitalization compared with patients without psychiatric disorders. The risk of multiple emergency department visits was particularly high for patients with either bipolar disorder or psychotic disorders.


CONCLUSIONS
Uninsured patients with psychiatric disorders appear to be heavy users of medical emergency department services. These findings may be helpful in developing more efficient strategies to serve the mental health needs of the uninsured.
Baillargeon
Jacques
J
Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555, USA. jbaillar@utmb.edu
Thomas
Chris R
CR
Williams
Brie
B
Begley
Charles E
CE
Sharma
Sarghi
S
Pollock
Brad H
BH
Murray
Owen J
OJ
Pulvino
John S
JS
Raimer
Ben
B
D000046:Academic Medical Centers; D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D038801:International Classification of Diseases; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008605:Mental Health Services; D015995:Prevalence; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology