Smokers, substance abusers, and patients with mental illness are three times more likely to become “frequent emergency room users,” meaning they visit the ER three or more times a year, according to a new study published in the journal Nursing Research.
Furthermore, within the general population, all medical services have seen a large increase in visits; this includes the ER as well as regular doctor visits.
The main focus of the study was to determine whether patients are replacing visits to their primary care physicians with trips to hospital ERs. They found that Americans with chronic diseases use both services equally and that, overall, medical care visits have increased dramatically in recent years.
“There are a few super-users who have been in the ER 40 or 50 times, but when we step back and look at the whole population, we see a different pattern,” said study leader Jessica Castner, Ph.D., R.N., a University at Buffalo emergency room utilization researcher and assistant professor in the University of Buffalo School of Nursing.
“People aren’t replacing their doctor; they are sicker, have more chronic diseases and are using everything more.”
Emergency department use could increase as more people receive health insurance coverage under the Affordable Care Act, placing a financial strain on health insurers, patients, and the overall health care system, says Castner.
For the study, researchers looked at 2009 data from the Department of Health of 56,000 people between the ages of 18-64 who used Medicaid to cover their medical expenses. Patients were divided into four categories: healthy; at risk for chronic disease; diagnosed with chronic disease; and diagnosed with a system failure, such as kidney or heart failure.
According to the findings, patients with chronic diseases weren’t the only high volume users of the ER; similar to smoking’s effect, substance abuse and psychiatric illnesses tripled a patient’s likelihood of becoming a “frequent ER user,” visiting the ER three or more times a year.
Future research will reanalyze emergency department use with focuses on specific chronic conditions.
Castner received a 2015 Junior Doctoral Award in Health Systems and Informatics Research from the Midwest Nursing Research Society last month for her research.
The study is published in the journal Nursing Research, a publication of the Eastern Nursing Research Society.
Source: University at Buffalo