title: Use of emergency departments among working age adults with disabilities: a problem of access and service needs.
abstract: OBJECTIVE
  To examine the relationship between emergency department (ED) use and access to medical care and prescription medications among working age Americans with disabilities.
  
  
  METHODS
  Pooled data from the 2006-2008 Medical Expenditure Panel Survey (MEPS), a U.S. health survey representative of community-dwelling civilians.
  
  
  METHODS
  We compared the health and service utilization of two groups of people with disabilities to a contrast group without disability. We modeled ED visits on the basis of disability status, measures of health and health conditions, access to care, and sociodemographics.
  
  
  METHODS
  These variables were aggregated from the household component, the medical condition, and event files to provide average annual estimates for the period spanning 2006-2008.
  
  
  RESULTS
  People with disabilities accounted for almost 40 percent of the annual visits made to U.S. EDs each year. Three key factors affect their ED use: access to regular medical care (including prescription medications), disability status, and the complexity of individuals' health profiles.
  
  
  CONCLUSIONS
  Given the volume of health conditions among people with disabilities, the ED will always play a role in their care. However, some ED visits could potentially be avoided if ongoing care were optimized.
authors.affiliation: Epidemiology and Biostatistics Section, National Institutes of Health, Mark O. Hatfield Clinical Research Center, Rehabilitation Medicine Department, Bethesda, MD 20892, USA. rasche@cc.nih.gov
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Rasch
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Gulley
authors.forename: Leighton
authors.initials: L
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: (MeSH): persons with disabilities; emergency medical services; health services accessibility