Patterns of Multiple Emergency Department Visits: Do Primary Care Physicians Matter?

Area of Science:

• Health Services Research
• Healthcare Management
• Public Health

Background:

• Overreliance on Emergency Departments (EDs) for routine care increases costs and creates gaps in care coordination and preventive services.
• Understanding factors driving frequent ED visits is crucial for optimizing healthcare resource allocation.

Purpose of the Study:

• To identify factors associated with multiple ED visits.
• To assess the impact of primary care physicians (PCPs) on patients' multiple ED visit rates.

Main Methods:

• Analysis of Geisinger Health Plan claims data (2013-2014) for 20,351 adult patients with >1 ED visit in 12 months.
• Linear regression models used patient characteristics and utilization patterns to explain variations in multiple ED visit rates, including PCP fixed effects.

Main Results:

• Multiple ED visits correlated with younger age (18-39), Medicaid insurance, and higher comorbidity.
• Increased physician office visits and inpatient admissions also associated with higher ED visit rates.
• PCP characteristics minimally improved explained variation (R² increased from 0.14 to 0.16).

Conclusions:

• Patient health conditions and care needs, rather than PCPs, primarily drive multiple ED visits.
• ED visits appear complementary to, not a substitute for, PCP visits.
• PCP-focused interventions are unlikely to significantly reduce overall ED utilization.