Ambulatory Care Among Young Adults in the United States

Fortuna, Robert J.; Robbins, Brett; Halterman, Jill S.

doi:10.7326/0003-4819-151-6-200909150-00002

Cited by 103 publications

(93 citation statements)

References 20 publications

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“…Young adults' reliance on the emergency department is likely driven by many factors including lack of insurance, limited preventive care, inadequate transition of care between providers, and a lack of a usual source of primary care. [4][5][6] We found that visits from uninsured patients were more likely than privately insured patients to occur in the emergency department, but this did not entirely account for young adults' increased use of the emergency department. After accounting for young adults' insurance status, injury status, and demographic factors, care continued to be considerably more likely to occur in the emergency department compared to other age groups, emphasizing the need to ensure access to a usual source of primary care.…”

Section: Discussionmentioning

confidence: 99%

“…We defined young adults as those between 20 and 29 years of age based on prior studies and because it represents a time period when many young adults lose their health insurance. 5,6,13 We also re-ran key analyses defining young adults as 18 to 24 years of age to ensure that our findings were not dependent on the definition of young adult. To allow for gender comparisons, we excluded visits related to pregnancy.…”

Section: Data Sourcementioning

confidence: 99%

“…2,3 Despite preventable risks, young adults frequently lack a usual source of ambulatory care and infrequently receive preventive care aimed at the greatest threats to their health. 4,5 Young adults are the most likely age group to lack health insurance, further hindering access to care and contributing to delayed treatments. 4,6 The US Department of Health and Human Services established several national objectives through Healthy People 2010 aimed at improving access to care, reducing preventable diseases, and reducing mortality in young adults, yet little progress has been made.…”

Section: Introductionmentioning

confidence: 99%

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Dependence on Emergency Care among Young Adults in the United States

et al. 2010

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BACKGROUND: Young adults have a high prevalence of many preventable diseases and frequently lack a usual source of ambulatory care, yet little is known about their use of the emergency department. OBJECTIVE: To characterize care provided to young adults in the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analysis of visits from young adults age 20 to 29 presenting to emergency departments (N=17,048) and outpatient departments (N=14,443) in the National Hospital Ambulatory Medical Care Survey and National Ambulatory Medical Care Survey. MAIN MEASURES: Visits to the emergency department compared to ambulatory offices. RESULTS: Emergency department care accounts for 21.6% of all health care visits from young adults, more than children/adolescents (12.6%; P<0.001) or patients 30 years and over (8.3%; P<0.001). Visits from young adults were considerably more likely to occur in the emergency department for both injury-related and noninjury-related reasons compared to children/adolescents (P<0.001) or older adults (P<0.001). Visits from black young adults were more likely than whites to occur in the emergency department (36.2% vs.19.2%; P< 0.001) rather than outpatient offices. The proportion of care delivered to black young adults in the emergency department increased between 1996 and 2006 (25.9% to 38.5%; P=0.001 for trend). In 2006, nearly half (48.5%) of all health care provided to young black men was delivered through emergency departments. The urgency of young adult emergency visits was less than other age groups and few (4.7%) resulted in hospital admission. CONCLUSIONS: A considerable amount of care provided to young adults is delivered through emergency departments. Trends suggest that young adults are increasingly relying on emergency departments for health care, while being seen for less urgent indications.KEY WORDS: emergency care; ambulatory care; young adults.

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Section: Discussionmentioning

confidence: 99%

Section: Data Sourcementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dependence on Emergency Care among Young Adults in the United States

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“…However, prior to ACA implementation, up to 70 % of young adult visits to primary care physicians included no preventive counseling [20]. Additionally, a recent review of preventive guidelines found that no specific guidelines exist for young adults, even though their developmental needs are markedly different from those of adolescents or older adults [21].…”

Section: Policy Recommendations To Improve Young Adult Healthmentioning

confidence: 99%

“…This critical issue has been addressed in recent legislative efforts to improve access to and quality of health care for all Americans. Many key provisions of the Patient Protection and Affordable Care Act (ACA) expand health insurance coverage options for young adults (ages [18][19][20][21][22][23][24][25] [2]. The ACA is a strong initial attempt to provide increased insurance coverage for young adults; however, the current provisions of the ACA are inadequate to address some of the systemic issues related to health care access and utilization among young adults.…”

Section: Introductionmentioning

confidence: 99%

The Affordable Care Act and implications for young adult health

Monaghan

2013

Behav. Med. Pract. Policy Res.

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In the USA, young adults are most likely to be uninsured and least likely to report a usual source of medical care than any age group. The Patient Protection and Affordable Care Act (ACA) recognizes the critical need for expanded insurance coverage for this age group, and multiple provisions of the ACA address insurance coverage and health care utilization in young adults. This paper presents a brief overview of the challenges of maintaining health insurance coverage and accessing health care in young adults, provisions of the ACA relevant to young adults, and early impact of the ACA on young adult health insurance status and health care access and utilization. We offer policy suggestions for behavioral health providers to address continued challenges related to health care for young adults. KEYWORDS

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Young Adult Preventive Health Care Guidelines

Ozer

Urquhart²,

Brindis³

et al. 2012

Arch Pediatr Adolesc Med

107

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Objectives: To (1) identify adolescent and adult clinical preventive services guidelines relevant to the young adult age group; (2) review, compare, and synthesize these guidelines, with emphasis on the extent to which professional guidelines are consistent with evidence-based guidelines developed by the US Preventive Services Task Force; and (3) recommend the next steps in the establishment and integration of preventive care guidelines for young adults. Design: Nonexperimental: an Internet search was conducted to identify relevant preventive care guidelines for the young adult group. Setting: The search included federal agencies and professional organizations that focus on health areas linked to the care of young adults or that provide health care to adolescents and young adults. Participants: National organizations, federal agencies, health professional associations, and medical societies. Main Outcome Measures: Preventive services guidelines for adolescents and adults that intersect with the age range of 18 to 26 years. Results: When the ages of 18 to 26 years are carved out of established professional guidelines across specialty groups, there is a broad number of recommendations, with many supported by sufficient evidence to receive a US Preventive Services Task Force grade of A or B that can inform the care of young adults. Conclusions: We recommend the establishment of young adult preventive health guidelines that reflect the current evidence-based recommendations that overlap with the young adult age group; we suggest clinician and health care system supports to facilitate the delivery of preventive services to young adults; and we emphasize prioritizing research in prevention areas in which sufficient evidence does not exist.

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Ambulatory Care Among Young Adults in the United States

Cited by 103 publications

References 20 publications

Dependence on Emergency Care among Young Adults in the United States

Dependence on Emergency Care among Young Adults in the United States

The Affordable Care Act and implications for young adult health

Young Adult Preventive Health Care Guidelines

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