Emergency Department Utilization, Hospital Admissions, and Physician Visits Among Elderly African American Persons

Abstract

This study uses a theoretical model of health services utilization to examine (a) emergency department utilization, (b) hospital admissions, and (c) office-based physician visits among a sample of 998 low-income elderly African American persons. Poisson Regression analysis was used to estimate the parameters specified in the Andersen behavioral model. Some of the more interesting results include the following: (a) a greater frequency of emergency room visits among respondents with a lower level of accessibility to physician services, (b) a lack of a significant relationship between some chronic illnesses such as diabetes and heart problems and the frequency of office-based physician visits, (c) a greater number of hospital admissions among insured persons, and (d) a significant impact of the health locus of control indexes on all three types of health care utilization. The results of this study challenge the assumption that hospital and emergency use are the results of nondiscretionary behavior.

The factors that influence private health insurance holders' choice between public and private emergency departments at the time of emergency

“…Previous literature indicated that health needs factors such as morbidity and injury were primary predictors for emergency care (Bazargan et al, 1998;Cherpitel, 1999;Cowie, Cowie, Underwood, Revitt, & Field, 2001;Fan et al, 2011;Guilbert et al, 2011;McCusker et al, 2003;Merrick et al, 2011;Neighbors, Zywiak, Stout, & Hoffmann, 2005;Shah, Manish N., Rathouz, & Chin, 2001;Shah, S. M. & Cook, 2008;Siegal, Falck, Jichuan, Carlson, & Massimino, 2006;Simmons et al, 2008;Weber, Showstack, Hunt, Colby, & Callaham, 2005;Wolinsky et al, 2008). Other health needs factors such as patients' perceived severity of illness and patients' health status were also associated with demand for emergency care (Baker, D. W. et al, 1995;Bazargan et al, 1998;Bianco et al, 2003;Callen et al, 2008;Lee et al, 2000;Olsson & Hansagi, 2001;Selasawati et al, 2007).…”

“…Individual health need factors, including morbidity, injury, and other health related factors, appear to be the primary predictors of ED utilization (Bazargan, Bazargan, & Baker, 1998;Cherpitel, 1999;McCusker, Karp, Cardin, Durand, & Morin, 2003;Wolinsky et al, 2008). A qualitative study (Ragin et al, 2005) of 1,579 patient interviews from 28 US hospitals found that medical necessity was the most frequently cited reason (95%) for patients attending EDs.…”

“…A qualitative study (Ragin et al, 2005) of 1,579 patient interviews from 28 US hospitals found that medical necessity was the most frequently cited reason (95%) for patients attending EDs. A cross-sectional study by Bazargan et al(1998) involving 998 lowincome elderly African Americans found that poor health was associated with an increased demand for ED use.…”

“…Other health needs factors such as patients' perceived severity of illness and patients' health status were also associated with demand for emergency care (Baker, D. W. et al, 1995;Bazargan et al, 1998;Bianco et al, 2003;Callen et al, 2008;Lee et al, 2000;Olsson & Hansagi, 2001;Selasawati et al, 2007).…”

Correlates of voluntary HIV testing and counseling among middle aged and older Latinas :

“…Throughout the decades of research utilizing the ABM, questions about whether the model sufficiently addresses psychosocial determinants of health, including culture (Andersen, 1995); social factors (Guendelman, 1991); psychological characteristics (Aday, 2001) and provider characteristics (Phillips, Morrison, Andersen, & Aday, 1998) have arisen. Some researchers have suggested that failure to add such factors to the ABM may contribute to the low predictive validity of ABM found in some previous studies (Bazargan & Bazargan, 1998;Keith & Jones, 1990;LaVeist & Keith, 1995 …”