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Emergency Department Visit Frequency Among Adults With Chronic Abdominal Pain: Findings From the 2023 US National
B Michael Ray1, Kyle J Kelleran2, Maria C Kaisler2
1Department of Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Objective:
Abdominal pain is a leading symptom prompting emergency department (ED) visits, but the specific contribution of chronic abdominal pain (CAP) to ED utilization is not well established. This study assessed whether CAP is associated with increased ED visits and identified predictors of ED utilization among individuals with CAP.
Methods:
Using the 2023 U.S. National Health Interview Survey (NHIS), CAP was defined as "bothersome" abdominal pain occurring "most" or "every day" over the prior 3 months. Comparisons were made by demographics, disability, mental health conditions, past medical history (PMH), and social determinants of health (SDOH). Multinomial regression models identified predictors of single and multiple ED visits, and an aggregate model assessed the impact of BioPsychoSocial variables.
Results:
CAP was reported by 2.8% (n = 4,585,878) of respondents and was associated with higher percentages of disability (31.7% vs. 7.2%), anxiety (51.9% vs. 17.6%), depression (49.4% vs. 17.8%), comorbidities such as hypertension (46.5% vs. 30.6%), and SDOH-related challenges like difficulty refilling prescriptions (23.8% vs. 5.2%) and cost-related care access (22.6% vs. 5.9%). CAP increased the odds of a single ED visit (OR: 2.2, 95% CI: 1.7-2.9) and multiple visits (OR: 4.2, 95% CI: 3.2-5.6). Adjusting for PMH reduced the odds of single ED visits by 33% (OR: 1.7, 95% CI: 1.2-2.3), while adjusting for SDOH reduced multiple visits by 100.1% (OR: 2.1, 95% CI: 1.5-2.9). The aggregate model reduced the odds of single and multiple visits by 49.4% and 120%, respectively (Single OR: 1.5, 95% CI: 1.1-2.0; Multiple OR 1.9, 95% CI: 1.4-2.7).
Conclusion:
This nationally representative analysis suggests that individuals with CAP have significantly higher ED utilization and face greater burdens of disability, mental health conditions, comorbidities, and SDOH-related barriers. These findings highlight the potential value of addressing BioPsychoSocial factors to reduce ED reliance and support comprehensive care for CAP patients.
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