Frequent Use of Emergency Departments in Saudi Public Hospitals
Department of Public Administration, College of Business Administration, King Saud University, Riyadh, Saudi Arabia. Asia-Pacific Journal of Public Health
(Impact Factor: 1.46).
12/2011; 27(2). DOI: 10.1177/1010539511431603
This study aims to determine the prevalence, factors and reasons associated with the frequent use of public emergency departments (EDs) in Riyadh, Saudi Arabia. The study employed a self-administered questionnaire to collect data from adult patients on aspects such as demographic characteristics, accessibility, and health-related factors. Bivariate and multivariate analyses were used to explore the issue. The results indicated that about 30% of respondents were considered as "frequent users" of the EDs. Males, older patients, those living closer to EDs, and patients who had chronic illnesses or were hospitalized in the past year were more likely to use EDs frequently. Moreover, the study found that patients who were labeled as "frequent users" of the EDs were also frequent users of "other" health care facilities. Health decision makers should facilitate primary health centers with necessary resources that fulfill the patients' health needs and reduce the burden on EDs.
Available from: Zach Grinspan
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ABSTRACT: The Korean National Health Insurance, which provides universal coverage for the entire Korean population, is now facing financial instability. Frequent emergency department (ED) users may represent a medically vulnerable population who could benefit from interventions that both improve care and lower costs. To understand the nature of frequent ED users in Korea, we analyzed claims data from a population-based national representative sample. We performed both bivariate and multivariable analyses to investigate the association between patient characteristics and frequent ED use (4+ ED visits in a year) using claims data of a 1% random sample of the Korean population, collected in 2009. Among 156,246 total ED users, 4,835 (3.1%) were frequent ED users. These patients accounted for 14% of 209,326 total ED visits and 17.2% of $76,253,784 total medical expenses generated from all ED visits in the 1% data sample. Frequent ED users tended to be older, male, and of lower socio-economic status compared with occasional ED users (p < 0.001 for each). Moreover, frequent ED users had longer stays in the hospital when admitted, higher probability of undergoing an operative procedure, and increased mortality. Among 8,425 primary diagnoses, alcohol-related complaints and schizophrenia showed the strongest positive correlation with the number of ED visits. Among the frequent ED users, mortality and annual outpatient department visits were significantly lower in the alcohol-related patient subgroup compared with other frequent ED users; furthermore, the rate was even lower than that for non-frequent ED users. Our findings suggest that expanding mental health and alcohol treatment programs may be a reasonable strategy to decrease the dependence of these patients on the ED.
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