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Emergency department utilization by adolescents

C U Lehmann1, J Barr, P J Kelly

  • 1Marshall University, School of Medicine, Huntington, WV.

The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine
|September 1, 1994
PubMed
Summary

Many rural adolescents lack primary care, leading to emergency department (ED) visits for non-emergencies. Accessible and acceptable primary care options are crucial for this population.

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Area of Science:

  • Public Health
  • Adolescent Medicine
  • Rural Health

Background:

  • Adolescent healthcare utilization patterns in rural settings are understudied.
  • Emergency departments (EDs) serve as a critical access point for healthcare in rural areas.
  • Understanding the characteristics and needs of adolescents seeking care in rural EDs is essential for improving health outcomes.

Purpose of the Study:

  • To examine how adolescents in a rural area use hospital emergency departments (EDs).
  • To identify the demographic characteristics of these adolescents.
  • To explore their reasons for seeking healthcare in an ED setting.

Main Methods:

  • A retrospective chart survey of 4932 adolescent visits (ages 12-18) to a rural ED in 1989.
  • Categorization of chief complaints and diagnoses into six groups: injury, pulmonary, Ob/Gyn, infection, nonspecific pain, and other.

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  • Analysis of patient demographics, insurance status, and healthcare access (e.g., telephone).

    • Main Results:

    • Visits increased with age; injury was the most common diagnosis (15% from motor vehicle accidents).
    • Adolescents with Medicaid or self-paying were more likely to have infection or Ob/Gyn diagnoses compared to privately insured patients.
    • Many adolescents lacked a primary care source and telephone access; 8.5% were discharged without a diagnosis, often for nonspecific pain.

    Conclusions:

    • A significant number of rural adolescents lack consistent primary care, leading to ED use for conditions manageable elsewhere.
    • This pattern results in preventable 'emergencies' and inefficient healthcare resource allocation.
    • Development of accessible and adolescent-friendly primary care services is recommended for rural communities.