Factors that Affect Nonurgent Emergency Department Visits in a Publicly Insured Pediatric Population: An...

Area of Science:

• Pediatrics
• Health Services Research
• Emergency Medicine

Background:

• Publicly insured children exhibit high rates of nonurgent emergency department visits.
• The specific factors contributing to this utilization pattern remain unclear.

Purpose of the Study:

• To identify the key factors associated with nonurgent emergency department (LAV) visits among publicly insured children.

Main Methods:

• Utilized univariate, multivariate, and classification/regression tree analyses.
• Examined demographics, emergency department visits, hospitalizations, missed appointments, zip code, and asthma status in 4,387 publicly insured children.
• Data collected from March 1 to December 31, 2011.

Main Results:

• Younger children (under 31.5 months) with at least one high-acuity emergency department visit represented the highest-risk group for nonurgent visits.
• Univariate analysis showed associations between high-acuity visits, hospitalizations, asthma, and nonurgent visits, with age inversely related.
• Missed appointments, asthma, hospitalizations, zip code, and gender were not significant predictors in multivariate or tree analyses.

Conclusions:

• Young age and a history of high-acuity emergency department visits are significant predictors of nonurgent emergency department use in this population.
• These findings highlight specific subgroups of publicly insured children who may benefit from targeted interventions to reduce nonurgent ED utilization.