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Member Research & Reports

Member Research & Reports

Texas A&M: Study Looks for Common Thread Between Critical Conditions and Use of Multiple Emergency Departments Among Frequent Users

Texas A&M School of Public Health researchers recently found that multisite users of emergency departments (EDs) were more likely to have diagnoses related to mental health, substance use and other urgent critical conditions. Lead author Dr. Theodoros Giannouchos’s study was published in the journal Medical Care.

A four-year period (2011–2014) was analyzed of outpatient ED visits by all adult ED users with more than five visits in a year in New York, Massachusetts & Florida, states that have a consistent and unique patient identifier that enabled tracking patients across different ED sites per calendar year.

Frequent use was defined as greater than five visits to the ED in one year. Patients with less than five visits per year were eliminated as well as children because they are less likely to be responsible for deciding when and where to seek care.

Across the three states, 1,033,626 patients were frequent users and accounted for 7,613,077 ED visits. Of these frequent users, 25 percent were multisite users and they accounted for 30 percent of all ED visits.

The team also found that frequent users with at least one visit for a mental health or substance use related diagnosis were more likely to use multiple sites, accounting for 15 percent of the ED population in New York, 18 percent in Massachusetts and 6 percent in Florida.

Findings shine the spotlight on the need to implement integrated mental health and substance use treatment programs across health systems in an effort to curb the number of frequent, duplicate, and sometimes, unnecessary ED visits.

The team suggests that a population health perspective should be applied and that multiple hospitals should be engaged in the effort. Also, it suggests a community-level preventative approach that might include the use of health information exchange data as stronger infrastructure for mental health and substance abuse.

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