Table 3.
Bivariate analyses of individual predictors for utilization of multiple EDs for patients with two or more ED visits.
| Patient with ≥ 2 Visits to the Same ED | Patients with ≥ 2 Visits to ≥ 2 Unique EDs | Difference (95% CI) | |
|---|---|---|---|
| Demographics | |||
| Age, Mean (SD) | 39.6 (24.6) | 38.6 (23.4) | −1.1 (−1.1, −1.0) |
| Years of Enrollment, Mean (SD) | 3.6 (1.9) | 3.7 (1.9) | 0.1 (0.1, 0.1) |
| Male Gender, N/Total (%) | 695,999/1,557,183 (44.7) | 772,849/1,775,439 (43.5) | −1.2 (−1.1, −1.3) |
| Number of ED Visits, Mean (SD) | 2.7 (1.6) | 3.8 (4.0) | 1.1 (1.1, 1.1)d |
| US Census Region | N = 1,555,434 | N=1,774,011 | |
| Northeast, N (%) | 438,591 (28.2) | 459,088 (25.9) | −2.3 (−2.4, −2.2) |
| Midwest, N (%) | 264,523 (17.0) | 275,651 (15.5) | −1.5 (−1.6, −1.4) |
| South, N (%) | 623,533 (40.1) | 801,632 (45.2) | 5.1 (5.0, 5.2) d |
| West, N (%) | 228,787 (14.7) | 237,640 (13.4) | −1.3 (−1.2, −1.4) |
| Major diagnostic Categories | N=1,557,260 | N=1,775,496 | |
| Nervous system, N (%) | 229,039 (14.7) | 333,280 (18.8) | 4.1 (4.0, 4.1)d |
| Eye, N (%) | 38,109 (2.5) | 54,351 (3.1) | 0.6 (0.6, 0.6) |
| Ear, nose, mouth, throat, N (%) | 248,675 (16.0) | 196,605 (16.7) | 0.7 (0.7, 0.8) |
| Respiratory system, N (%) | 264,411 (17.0) | 331,557 (18.7) | 1.7 (1.6, 1.8) |
| Circulatory system, N (%) | 336,360 (21.6) | 451,804 (25.5) | 3.8 (3.8, 3.9) |
| Digestive system, N (%) | 413,419 (26.6) | 537,369 (30.3) | 3.7 (3.6, 3.8) |
| Liver, GB, and pancreas, N (%) | 24,954 (1.6) | 33,459 (1.9) | 0.3 (0.3, 0.3) |
| Musculoskeletal, N (%) | 484,064 (31.1) | 626,674 (35.3) | 4.2 (4.2, 4.3) |
| Skin and soft tissue, N (%) | 255,682 (16.4) | 302,636 (17.1) | 0.6 (0.5, 0.7) |
| Endocrine and metabolic, N (%) | 53,770 (3.5) | 75,833 (4.3) | 0.8 (0.8, 0.9) |
| Kidney and urinary tract, N (%) | 164,748 (10.6) | 206,989 (11.7) | 1.1 (1.0, 1.1) |
| Male reproductive system, N (%) | 5,203 (0.3) | 6,998 (0.4) | 0.1 (0.0–0.1) |
| Female reproductive system, N (%) | 48,176 (3.1) | 82,275 (4.6) | 1.5 (1.5, 1.6) |
| Pregnancy and childbirth, N (%) | 60,716 (3.9) | 82,764 (4.7) | 0.8 (0.7, 0.8) |
| Newborn and neonatal,c N (%) | 2,015 (0.1) | 2,435 (0.1) | 0.0 (0.0, 0.0) |
| Blood and immunological, N (%) | 16,898 (1.1) | 23,480 (1.3) | 0.2 (0.2, 0.3) |
| Myeloproliferative, N (%) | 3,686 (0.2) | 5,138 (0.3) | 0.1 (0.0, 0.1) |
| Infectious and parasitic, N (%) | 103,802 (6.7) | 122,558 (6.9) | 0.2 (0.2, 0.3) |
| Mental disorders, N (%) | 55,472 (3.6) | 109,342 (6.2) | 2.6 (2.6, 2.6)d |
| Alcohol and drugs, N (%) | 13,671 (0.9) | 38,293 (2.2) | 1.3 (1.3, 1.3)d |
| Injuries/poisoning/Toxic Effects Drugs, N (%) | 408,287 (26.2) | 518,291 (29.2) | 3.0 (2.9, 3.0) |
| Burns, N (%) | 9,89 2(0.6) | 14,362 (0.8) | 0.2 (0.2, 0.2) |
| Factors influencing health, N (%) | 108,970 (7.0) | 154,512 (8.7) | 1.7 (1.6, 1.8) |
| Multiple trauma, N (%) | 1,911 (0.1) | 3,183 (0.2) | 0.1 (0.0, 0.1) |
| Human Immunodeficiency Virus, N (%) | 186 (0.01) | 349 (0.02) | 0.01 (0.1, 0.0) |
| Highest Visit Complexity | N = 1,557,269 | N=1,775,496 | |
| 99281 (Straight Forward) | 1,554(0.1) | 196 (0.01) | −0.1 (−0.1, −0.1) |
| 92282 (Low Complexity) | 12,495 (0.8) | 5,705 (0.3) | −0.5 (−0.5, −0.5) |
| 99283 (Moderately Low Complexity) | 253,492 (16.3) | 204,984 (11.5) | −4.7 (−4.8, −4.7)d |
| 99284 (Moderately High Complexity) | 547,954 (35.2) | 553,633 (31.2) | −4.0 (−4.1, −3.9) |
| 99285 (High Complexity) | 741,774 (47.6) | 1,010,978 (56.9) | 9.3 (9.2, 9.4)d |
Abbreviations: ED= emergency department, N= number of patients, SD= standard deviation, %= percent, Dx= diagnosis.
T-tests were used to compare use of single vs multiple EDs for continuous variables
Values for categorical variables are for the number and percent of patients who visited multiple EDs. Chi-square tests or logistic regression was used to evaluate proportions who visited multiple EDs. P-values are from Chi-square tests for two-category variables (gender, diagnoses) and for Type 3 tests for variable with five categories (region, maximum 9928- CPT code). All p-values are <.001 unless otherwise indicated.
p=0.053.
Cohen’s statistic > 0.1