Exploring Which Patients Use Their Closest Emergency Departments Using Geocoded Data

Area of Science:

• Healthcare Management
• Patient Behavior Studies
• Emergency Medicine

Background:

• Annually, approximately 20% of U.S. adults utilize emergency department (ED) services.
• Limited understanding exists regarding patient decision-making processes when selecting an ED.

Purpose of the Study:

• To investigate patient discretion in choosing among EDs.
• To identify characteristics influencing ED choice.
• To analyze the relationship between ED choice and patient-reported care experiences.

Main Methods:

• Surveyed 4647 adult patients discharged from 16 hospital-based EDs (January-March 2018).
• Geocoded patient and ED addresses to calculate travel distances.
• Employed linear regression to assess the association between choosing the closest ED and patient experience measures.

Main Results:

• 43.6% of patients visited their nearest ED (average distance: 5.7 miles).
• Patients selecting a farther ED often presented with more urgent conditions and favored higher-rated, metropolitan, teaching hospitals with specialized services.
• Choosing a farther ED correlated with higher likelihood of recommending the facility.

Conclusions:

• Less than half of patients utilize the closest emergency department.
• Patient ED choice is influenced by perceived hospital quality and specialized services.
• Selecting a farther ED is associated with more positive patient experiences and higher recommendation rates.