Table 2. Emergency Department–Level Care Among Denial Diagnosis Visits by 15 Most Frequent Presenting Symptoms.
| Presenting Symptoma | Unweighted No. | Visits Received ED-Level Careb | |
|---|---|---|---|
| Unweighted No. | Weighted % (95% CI)c | ||
| Total | 4440 | 1749 | 39.7 (37.2-42.3) |
| Back pain, ache, soreness, discomfort | 241 | 93 | 36.0 (28.1-44.7) |
| Throat soreness | 193 | 54 | 33.2 (23.0-45.3) |
| Cough | 158 | 78 | 43.7 (33.3-54.8) |
| Skin rash | 155 | 50 | 35.3 (25.1-47.0) |
| Ankle pain, ache, soreness, discomfort | 119 | 25 | NC |
| Foot and toe pain, ache, soreness, discomfort | 132 | 29 | NC |
| Toothache | 93 | 14 | NC |
| Leg pain, ache, soreness, discomfort | 122 | 69 | 50.7 (38.5-62.8) |
| Low back pain, ache, soreness, discomfort | 134 | 45 | 32.9 (24.3-42.8) |
| Abdominal pain, cramps, spasms, none otherwise specified | 105 | 99 | 96.2 (89.7-98.7) |
| Earache, pain | 99 | 14 | NC |
| Knee pain, ache, soreness, discomfort | 99 | 22 | NC |
| Shoulder pain, ache, soreness, discomfort | 100 | 29 | NC |
| Headache, pain in head | 77 | 41 | 55.8 (40.5-70.1) |
| Chest pain | 69 | 53 | 75.5 (59.9-86.5) |
Abbreviations: ED, emergency department; NC, not calculated.
a
Presenting symptoms were classified using the reason for visit codes.
b
We defined ED-level care as a visit that was triaged as urgent or emergent or received 2 or more diagnostic tests. Of note, no patients in the denial diagnosis visit cohort were admitted because admission was an criterion for exclusion from Anthem's coverage denial policy.
c
Weighted proportions for cells with fewer than 30 numerator observations were not calculated because it produces unstable estimates.