title: The association between the availability of ambulatory care and non-emergency treatment in emergency medicine departments: a comprehensive and nationwide validation.
abstract: OBJECTIVE
  To quantify dynamic availability of ambulatory care, and to examine possible associations with non-emergency treatments in emergency departments (EDs).
  
  
  METHODS
  Longitudinal data from the Taiwan National health Insurance Research Database were used to evaluate 749,584 emergency-medicine cases occurring between 2005 and 2010 according to a modified New York University algorithm. Multivariable-cumulative-logistic-regression analysis with generalized estimating-equation methods was used to determine associations between availability of ambulatory care and the urgency of patients' medical needs during ED visits.
  
  
  RESULTS
  More than half (53.04%) of the ED visits that were evaluated in our study were classified as non-emergencies, and over half of these occurred despite a high availability of ambulatory care facilities (median > 96%). Compared with patients in areas with a low availability of ambulatory care, patients in areas of medium to high availability showed approximately 0.8 times lower odds ratios for associations with non-emergency ED visits.
  
  
  CONCLUSIONS
  Non-emergency ED visits may be reduced by increasing the availability of ambulatory care facilities in areas with deficits in the availability of such facilities. However, increasing the availability of ambulatory care by raising the number of available ambulatory care physicians or the number of ambulatory care facilities may not reduce non-emergency ED visits in areas with medium to high availability of ambulatory care facilities.
authors.affiliation: Department of Information Management, College of Informatics, Yuan Ze University, No. 135 Yuan-Tung Road, Chung-Li, Taiwan. clchan@saturn.yzu.edu.tw
authors.forename: Chien-Lung
authors.initials: CL
authors.lastname: Chan
authors.forename: Wender
authors.initials: W
authors.lastname: Lin
authors.forename: Nan-Ping
authors.initials: NP
authors.lastname: Yang
authors.forename: Hsin-Tsung
authors.initials: HT
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data / Q000600:supply & distribution*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult