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Mental Health and Drivers of Need in Emergent and Non-Emergent Emergency Department (ED) Use: Do Living Location and Non-Emergent Care Sources Matter?

Author

Listed:
  • Moira C. McManus

    (Community and Environmental Health, College of Health Sciences, Old Dominion University; Norfolk, VA 757-683-4259, USA)

  • Robert J. Cramer

    (Community and Environmental Health, College of Health Sciences, Old Dominion University; Norfolk, VA 757-683-4259, USA)

  • Maureen Boshier

    (Community and Environmental Health, College of Health Sciences, Old Dominion University; Norfolk, VA 757-683-4259, USA)

  • Muge Akpinar-Elci

    (Community and Environmental Health, College of Health Sciences, Old Dominion University; Norfolk, VA 757-683-4259, USA)

  • Bonnie Van Lunen

    (Physical Therapy and Athletic Training, College of Health Sciences, Old Dominion University; Norfolk, VA 757-683-4519, USA)

Abstract

Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations. Concerning moderating effects, Spanish/Hispanic origin was associated with increased likelihood for emergent ED use in the rural living location model, and non-emergent ED use for the no non-emergent source model. ‘Other’ ethnic origin increased the likelihood of emergent ED use for rural living location and no non-emergent source models. The findings reveal ‘need’, including mental health admissions, as the largest driver for ED use. This may be due to mental healthcare access, or patients with mental health emergencies being transported via first responders to the ED, as in the case of suicide, self-harm, manic episodes or psychotic episodes. Further educating ED staff on this patient population through gatekeeper training may ensure patients receive the best treatment and aid in driving access to mental healthcare delivery changes.

Suggested Citation

  • Moira C. McManus & Robert J. Cramer & Maureen Boshier & Muge Akpinar-Elci & Bonnie Van Lunen, 2018. "Mental Health and Drivers of Need in Emergent and Non-Emergent Emergency Department (ED) Use: Do Living Location and Non-Emergent Care Sources Matter?," IJERPH, MDPI, vol. 15(1), pages 1-15, January.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:1:p:129-:d:126789
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    References listed on IDEAS

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    1. Wong, Frances Kam Yuet & Chow, Susan & Chang, Katherine & Lee, Albert & Liu, Jiexin, 2004. "Effects of nurse follow-up on emergency room revisits: a randomized controlled trial," Social Science & Medicine, Elsevier, vol. 59(11), pages 2207-2218, December.
    2. Ghosh, C. S. & Ravindran, P. & Joshi, M. & Stearns, Sally C., 1998. "Reductions in hospital use from self management training for chronic asthmatics," Social Science & Medicine, Elsevier, vol. 46(8), pages 1087-1093, April.
    3. Bharel, M. & Lin, W.-C. & Zhang, J. & O'Connell, E. & Taube, R. & Clark, R.E., 2013. "Health care utilization patterns of homeless individuals in Boston: Preparing for Medicaid expansion under the Affordable Care Act," American Journal of Public Health, American Public Health Association, vol. 103(S2), pages 311-317.
    4. McClelland, M. & Asplin, B. & Epstein, S.K. & Kocher, K.E. & Pilgrim, R. & Pines, J. & Rabin, E.J. & Rathlev, N.K., 2014. "The affordable care act and emergency care," American Journal of Public Health, American Public Health Association, vol. 104(10), pages 8-10.
    5. repec:mpr:mprres:6770 is not listed on IDEAS
    6. Emily Saurman & David Lyle & Sue Kirby & Russell Roberts, 2014. "Assessing Program Efficiency: A Time and Motion Study of the Mental Health Emergency Care — Rural Access Program in NSW Australia," IJERPH, MDPI, vol. 11(8), pages 1-12, July.
    Full references (including those not matched with items on IDEAS)

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