Table 1.
Characteristics of study population
| Appropriateuse score method | PossibleGP use method | Resourceutilisation method | Total | |||||||
| Inappropriate ED use | Appropriate ED use | P value | Inappropriate ED use | Appropriate ED use | P value | Inappropriate ED use | Appropriate ED use | P value | ||
| n=6938 (23.59) | n=22 469 (76.41) | n=8052 (27.38) | n=21 355 (72.62) | n=3968 (13.49) | n=25 439 (86.51) | N=29 407 | ||||
| Patient characteristics | ||||||||||
| Age, years, n (%) | ||||||||||
| 15–24 | 1665 (24.00) | 3627 (16.14) | <0.0001 | 2018 (25.06) | 3275 (15.33) | <0.0001 | 1012 (25.50) | 4280 (16.82) | <0.0001 | 5292 (18.00) |
| 25–34 | 1414 (20.38) | 3615 (16.09) | 1747 (21.70) | 3282 (15.37) | 931 (23.46) | 4098 (16.11) | 5029 (17.10) | |||
| 35–44 | 1120 (16.14) | 3191 (14.20) | 1322 (16.42) | 2989 (14.00) | 703 (17.72) | 3608 (14.18) | 4311 (14.66) | |||
| 45–54 | 929 (13.39) | 2942 (13.09) | 1056 (13.11) | 2815 (13.18) | 583 (14.69) | 3288 (12.93) | 3871 (13.16) | |||
| 55–64 | 704 (10.15) | 2573 (11.45) | 774 (9.61) | 2503 (11.72) | 362 (9.12) | 2915 (11.46) | 3277 (11.14) | |||
| 65–74 | 459 (6,62) | 2002 (8.91) | 479 (5.95) | 1982 (9.28) | 196 (4.94) | 2265 (8.90) | 2461 (8.37) | |||
| 75–84 | 392 (5,65) | 2492 (11.09) | 399 (4.96) | 2485 (11.64) | 126 (3.18) | 2758 (10.84) | 2884 (9.81) | |||
| >85 | 255 (3,68) | 2027 (9.02) | 257 (3.19) | 2025 (9.48) | 55 (1.39) | 2227 (8.75) | 2282 (7.76) | |||
| Sex, n (%) | ||||||||||
| Male | 3447 (49.68) | 11 635 (51.78) | 0.0056 | 3963 (49.22) | 11 119 (52.07) | <0.0001 | 2106 (53.07) | 12 976 (51.01) | 0.0086 | 15 082 (51.29) |
| Female | 3397 (48.96) | 10 575 (47.06) | 3986 (49.50) | 9986 (46.76) | 1804 (45.46) | 12 168 (47.83) | 13 972 (47.51) | |||
| Missing data | 94 (1.35) | 259 (1.15) | 103 (1.28) | 250 (1.17) | 58 (1.46) | 295 (1.16) | 353 (1.20) | |||
| Supplementary health insurance, n (%) | ||||||||||
| None | 590 (8.50) | 1366 (6.08) | <0.0001 | 650 (8.07) | 1306 (6.12) | <0.0001 | 341 (8.59) | 1615 (6.35) | <0.0001 | 1956 (6.65) |
| Universal complementary health coverage | 637 (9.18) | 1489 (6.63) | 755 (9.38) | 1371 (6.42) | 406 (10.23) | 1720 (6.76) | 2126 (7.23) | |||
| Private | 4664 (67.22) | 16 373 (72.87) | 5614 (69.72) | 15 423 (72.22) | 2548 (64.21) | 18 489 (72.68) | 21 037 (71.54) | |||
| Missing data | 1047 (15.09) | 3241 (14.42) | 1033 (12.83) | 3255 (15.24) | 673 (16.96) | 3615 (14.21) | 4288 (14.58) | |||
| Health insurance, n (%) | ||||||||||
| None or state medical assistance | 212 (3.06) | 461 (2.05) | <0.0001 | 229 (2.84) | 444 (2.08) | <0.0001 | 140 (3.53) | 533 (2.10) | <0.0001 | 673 (2.29) |
| Public health insurance | 6021 (86.78) | 19 698 (87.67) | 7161 (88.93) | 18 558 (86.90) | 3365 (84.80) | 22 354 (87.87) | 25 719 (87.46) | |||
| Missing data | 705 (10.16) | 2310 (10.28) | 662 (8.22) | 2353 (11.02) | 463 (11.67) | 2552 (10.03) | 3015 (10.25) | |||
| Employed status, n (%) | ||||||||||
| Employed | 2860 (41.22) | 8429 (37.51) | <0.0001 | 3641 (45.22) | 7648 (35.81) | <0.0001 | 1737 (43.78) | 9552 (37.55) | <0.0001 | 11 289 (38.39) |
| Unemployed | 624 (8.99) | 1438 (6.40) | 695 (8.63) | 1367 (6.40) | 390 (9.83) | 1672 (6.57) | 2062 (7.01) | |||
| Inactive | 2504 (36.09) | 9702 (43.18) | 2762 (34.30) | 9444 (44.22) | 1199 (30.22) | 11 007 (43.27) | 12 206 (41.51) | |||
| Missing data | 950 (13.69) | 2900 (12.91) | 954 (11.85) | 2896 (13.56) | 642 (16.68) | 3208 (12.61) | 3850 (13.09) | |||
| Level of education, n (%) | ||||||||||
| High-school graduation or less | 4436 (63.94) | 13 867 (61.72) | 0.0026 | 5225 (64.89) | 12 078 (61.24) | <0.0001 | 2446 (61.64) | 15 857 (62.33) | 0.4834 | 18 303 (62.24) |
| More than high school graduation | 1048 (15.11) | 3516 (15.65) | 1328 (16.49) | 3236 (15.15) | 641 (16.15) | 3923 (15.42) | 4564 (15.52) | |||
| Missing data | 1454 (20.96) | 5086 (22.64) | 1499 (18.62) | 5041 (23.61) | 881 (22.20) | 5659 (22.25) | 6540 (22.24) | |||
| Residence, n (%) | ||||||||||
| Home | 6100 (87.92) | 19 497 (86.77) | <0.0001 | 7299 (90.65) | 18 298 (85.68) | <0.0001 | 3477 (87.63) | 22 129 (86.95) | <0.0001 | 25 597 (87.04) |
| Institution | 163 (2.35) | 892 (3.97) | 142 (1.76) | 913 (4.28) | 49 (1.23) | 1006 (3.95) | 1055 (3.59) | |||
| Other | 675 (9.73) | 2080 (9.26) | 611 (7.59) | 2144 (10.04) | 442 (11.14) | 2313 (9.09) | 2755 (9.37) | |||
| Having a GP, n (%) | ||||||||||
| Yes | 5930 (85.47) | 19 816 (88.19) | <0.0001 | 7025 (87.25) | 18 721 (87.67) | <0.0001 | 3222 (81.20) | 22 524 (88.54) | <0.0001 | 25 746 (87.55) |
| No | 603 (8.69) | 1334 (5.94) | 665 (8.26) | 1272 (5.96) | 387 (9.75) | 1550 (6.09) | 1937 (6.59) | |||
| Missing data | 405 (5.84) | 1319 (5.87) | 362 (4.50) | 1362 (6.38) | 359 (9.05) | 1365 (5.37) | 1724 (5.86) | |||
| ED visit characteristics | ||||||||||
| Chief complaint of ED visit, n (%) | ||||||||||
| Medical complaint | 4622 (66.62) | 13 107 (58.33) | <0.0001 | 5250 (65.20) | 12 479 (58.44) | <0.0001 | 2702 (68.09) | 15 027 (59.07) | <0.0001 | 17 729 (60.29) |
| Traumatic injury | 1746 (25.16) | 7322 (32.59) | 2335 (29.00) | 6733 (31.53) | 773 (19.48) | 8295 (32.61) | 9068 (30.84) | |||
| Missing data | 570 (8.22) | 2040 (9.08) | 467 (5.80) | 2143 (10.04) | 493 (12.42) | 2117 (8.32) | 2610 (8.88) | |||
| Onset of complaint, n (%) | ||||||||||
| The day of ED visit | 2638 (38.02) | 11 713 (52.13) | <0.0001 | 3577 (44.42) | 10 774 (50.45) | <0.0001 | 1607 (40.50) | 12 744 (50.10) | <0.0001 | 14 351 (48.80) |
| Before the day of ED visit | 3773 (54.38) | 8866 (39.46) | 4058 (50.40) | 8581 (40.18) | 1907 (48.06) | 10 732 (42.19) | 12 639 (42.98) | |||
| Missing data | 527 (7.60) | 1890 (8.41) | 417 (5.18) | 2000 (9.37) | 454 (11.44) | 1963 (7.72) | 2417 (8.22) | |||
| Time of ED arrival, n (%) | ||||||||||
| 08:00–20:00 | 5069 (73.06) | 16 682 (74.24) | 0.0496 | 5731 (71.17) | 16 020 (75.02) | <0.0001 | 2689 (67.77) | 19 062 (74.93) | <0.0001 | 21 751 (73.97) |
| 20:00–08:00 | 1869 (26.94) | 5787 (25.76) | 2321 (28.83) | 5335 (24.98) | 1279 (32.23) | 6377 (25.07) | 7656 (26.03) | |||
| Distance from home to ED, n (%) | ||||||||||
| ≤10 km | 4372 (63.02) | 13 129 (58.43) | <0.0001 | 5102 (63.36) | 12 399 (58.06) | <0.0001 | 2601 (65.55) | 14 900 (58.57) | <0.0001 | 17 501 (59.51) |
| >10 km | 2386 (34.39) | 8740 (38.90) | 2751 (34.17) | 8375 (39.22) | 1267 (31.93) | 9859 (38.76) | 11 126 (37.83) | |||
| Missing data | 180 (2.59) | 600 (2.67) | 199 (2.47) | 581 (2.72) | 100 (2.52) | 680 (2.67) | 780 (2.65) | |||
| Type of resources used, n (%) | ||||||||||
| Radiological imaging | 2052 (29.58) | 12 681 (56.44) | <0.0001 | 2527 (31.38) | 12 206 (57.16) | <0.0001 | ** | ** | 14 733 (50.10) | |
| Blood tests | 1511 (21.78) | 11 328 (50.42) | <0.0001 | 1940 (24.09) | 10 899 (51.04) | <0.0001 | ** | ** | 12 839 (43.66) | |
| Therapeutic care | 1702 (24.53) | 11 254 (50.09) | <0.0001 | 2359 (29.30) | 10 597 (49.62) | <0.0001 | ** | ** | 12 956 (44.06) | |
| Inappropriateness in other measures, n (%) | ||||||||||
| Appropriate use score method | ** | ** | 4800 (59.61) | 2138 (10.01) | 2303 (58.04) | 4625 (18.20) | 6938 (23.59) | |||
| GP possible use method | 4800 (69.18) | 3252 (14.47) | ** | ** | 2463 (62.07) | 5573 (21.93) | 8052 (27.38) | |||
| Resource utilisation method | 2303 (33.19) | 1665 (7.41) | 2463 (30.59) | 1505 (7.05) | ** | ** | 3968 (13.49) | |||
ED, emergency department; GP, general practitioner.