Reasons for emergency department use: do frequent users differ?

Kelly M. Doran, Ashley C. Colucci, Stephen P. Wall, Nick D. Williams, Robert A. Hessler, Lewis R. Goldfrank, Maria C. Raven

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: To examine patients' reasons for using the emergency department (ED) for low-acuity health complaints, and determine whether reasons differed for frequent ED users versus nonfrequent ED users.

STUDY DESIGN: Prospective cross-sectional survey.

METHODS: Patients presenting to an urban public hospital for low-acuity health complaints were surveyed about their reasons for visiting the ED rather than a private doctor's office or clinic. Patients with 3 or more visits to the study hospital ED over the past year were classified as frequent ED users. Multivariable logistic regression was used to determine if frequent ED users gave different reasons for ED use than nonfrequent ED users, while controlling for differences in other baseline patient characteristics.

RESULTS: 940 patients, including 163 frequent ED users, completed the study questionnaire. Commonly cited reasons for using the ED were that coming to the ED was easier than making a clinic appointment (82.3% agreed); the problem could not wait (78.8%); they didn't know how to make a clinic appointment (66.7%); they felt the ED provided better care (56.7%); and they believed the clinic would cost more (54.8%). After controlling for other patient characteristics, there were no significant differences found in reasons for ED use given by frequent versus nonfrequent ED users.

CONCLUSIONS: Frequent ED users gave similar reasons for using the ED for low-acuity health complaints compared with nonfrequent ED users. Access, convenience, cost, and quality concerns, as well as feeling that ED care was needed, were all commonly cited as reasons for using the ED.

Original languageEnglish (US)
Pages (from-to)e506-e514
JournalThe American journal of managed care
Issue number11
StatePublished - 2014

ASJC Scopus subject areas

  • Health Policy


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