Analysis of chronic emergency department use

Nurs Econ. 1999 Jul-Aug;17(4):207-13, 237.


This retrospective emergency department (ED) chart review study examined the relationship between acuity level and the type of insurance in a patient population who used the ED on a chronic basis (seven or more times in the calendar year 1996). Of 1,185 patients seen in the ED in 1996, 122 had between 7 and 29 visits. In the study population: 62.5% of their visits were classified as nonurgent; 42.6% of the nonurgent visits were made by those with insurance; the highest frequency of visits took place between 8:00 am and 4:00 pm when most alternative nonemergency facilities are open. Some of the factors seen as influencing overuse of the ED include: the fact that some chronic use appeared to be associated with psychiatric conditions including substance abuse and patients with recurrent chest pain; and patient's perceptions that access to lab and X-ray facilities are readily available within the ED.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Chronic Disease
  • Emergency Service, Hospital / statistics & numerical data*
  • Health Services Misuse / statistics & numerical data*
  • Hospitals, Urban / statistics & numerical data
  • Humans
  • Insurance, Health / statistics & numerical data*
  • Medically Uninsured / statistics & numerical data*
  • Middle Aged
  • Retrospective Studies
  • Severity of Illness Index*
  • Virginia