Disparities in Potentially Avoidable Emergency Department (ED) Care

Johnson, Pamela Jo; Ghildayal, Neha; Ward, Andrew; Westgard, Bjorn; Boland, Lori L.; Hokanson, Jon S.

doi:10.1097/mlr.0b013e318270bad4

Cited by 109 publications

(120 citation statements)

References 40 publications

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“…Gallagher et al 16 concluded homeless individuals with non-Medicaid insurance were the most likely to have a usual source of care; suggesting that those with Medicaid insurance had difficulty obtaining a usual source of care. Similarly, Johnson et al 34 found that the probability for being admitted to the ED for an ACS condition was highest among publicly insured patients in the general population. These findings further support that insurance alone does not increase access to health services, especially to primary care services.…”

Section: Improving Health Policy Initiativesmentioning

confidence: 99%

“…16 On the contrary, previous research found women have a higher probability for being admitted for an ACS condition, indicating that housed women have more barriers to primary care services than housed men. 34,44 This disparity suggests homeless women may have access to additional resources that are unavailable to nonhomeless women. The majority of homeless families are headed by women, which may indirectly increase the number of available health-related resources.…”

Section: Identifying At-risk Subpopulationsmentioning

confidence: 99%

“…Trend analyses indicate ACS hospitalizations have been increasing among Black patients, especially for acute and preventable conditions such as urinary tract infections and dehydration. 44, 46 Johnson et al 34 determined the odds of being admitted through the ED for an ACS condition were the highest for Blacks and Hispanics. Other studies concluded being Black as a predictor for an ACS hospitalization when compared with Whites.…”

Section: Identifying At-risk Subpopulationsmentioning

confidence: 99%

See 2 more Smart Citations

Access to Primary Care Services Among the Homeless

White

Newman

2014

J Prim Care Community Health

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Objective: To identify barriers and facilitators to primary care access among the homeless using the Equity of Access to Medical Care Framework and to provide recommendations for medical and public health practitioners to improve health among this underserved population. Methods: A quasi-systematic review of the literature was conducted using the PubMed, CINAHL, and PsycINFO databases. Study elements from articles in the final analysis were extracted and categorized into dimensions of access from the Framework. Results: The review identified multiple barriers to primary care access for the homeless. This included lack of insurance coverage and competing priorities. Facilitators to access included tailored health care delivery systems and having a regular source of care. Conclusion: This review provides evidence that health policy initiatives, patient-centered care, and targeted interventions can assist with improving primary care access among the homeless.

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Section: Improving Health Policy Initiativesmentioning

confidence: 99%

Section: Identifying At-risk Subpopulationsmentioning

confidence: 99%

Section: Identifying At-risk Subpopulationsmentioning

confidence: 99%

See 1 more Smart Citation

Access to Primary Care Services Among the Homeless

White

Newman

2014

J Prim Care Community Health

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“…Patient factors which are associated with increased ED utilization for non-urgent care include inadequate health literacy (11), advanced age, female gender, poverty and minority race (12). After discharge from the ED, patients face substantial barriers in obtaining appropriate follow-up care.…”

Section: With Challenge Comes Opportunitymentioning

confidence: 99%

Primary Care in the Emergency Department – An Untapped Resource for Public Health Research and Innovation

Brody¹,

Clark²,

Flack³

et al. 2014

West Indian Med J

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“…[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Overall we found four common approaches used to define preventable ED visits: 1) Ambulatory Care Sensitive Conditions (ACSCs) (N = 7), 2) Low Acuity/ low intensity visits (N = 5), 3) New York University (NYU) (Billings) Algorithm (N = 3) and 4) hospital admission vs. non-admission (N = 1). Overall the proportion of preventable ED visits identified by these studies ranged from 5.7% to 74.2%.…”

Section: Literature Searchmentioning

confidence: 99%

Defining potentially preventable emergency department visits for older adults

Latham

Ackroyd‐Stolarz

2017

IJH

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Objective: As older adults become increasingly reliant on emergency departments (EDs) for care, there is an interest in determining what types of ED visits by this population may be preventable, or amenable to other forms of care. The aim of this project was to explore the concept of preventable ED visits by older adults. Methods: We conducted a literature search to identify definitions of "preventable" or "avoidable" ED visits. We then applied a definition of preventable ED visits to an administrative data set consisting of ED visit data extracted from four sites in Halifax, Nova Scotia, Canada. Visits for patients 65 years of age or older were eligible for inclusion. Visits were categorized using triage level and discharge diagnosis. Results: Four methods of defining preventable ED visits were identified in our literature search: 1) Ambulatory Care Sensitive Conditions (ACSCs) (N = 7), 2) Low Acuity/low intensity visits (N = 5), 3) New York University (NYU) (Billings) Algorithm (N = 3) and 4) hospital admission vs. non-admission (N = 1). We categorized 34,454 ED visits from our dataset using a modified definition of preventable ED visits that included ACSCs (15.3%) as well as low acuity visits that required no testing or hospital admission (9.9%). Conclusions: Our results suggest that approximately 25% of ED visits by older adults may be preventable or amenable to other forms of care. This data may be useful in the planning of care delivery appropriate for the needs of this population.

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Disparities in Potentially Avoidable Emergency Department (ED) Care

Cited by 109 publications

References 40 publications

Access to Primary Care Services Among the Homeless

Access to Primary Care Services Among the Homeless

Primary Care in the Emergency Department – An Untapped Resource for Public Health Research and Innovation

Defining potentially preventable emergency department visits for older adults

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