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Neighborhood socioeconomic factors and characteristics correlated with avoidable emergency department visits: A spatial analysis of a Canadian academic hospital

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  • Ryan P Strum
  • Brent McLeod
  • Andrew P Costa
  • Shawn Mondoux

Abstract

Introduction: The influence of neighborhood characteristics and socioeconomic status (SES) factors on avoidable emergency department (ED) utilization is not well understood in a universal healthcare system. We examined correlations between these factors and avoidable ED visits at a Canadian academic hospital. Materials and methods: We conducted a retrospective cohort study using administrative ED data from a hospital in Hamilton, Canada from April 1, 2018 to August 31, 2023, and neighborhood data from the Statistics Canada Census of Population 2021. Avoidable visits were classified using the Emergency Department Avoidability Classification (EDAC), and mapped to neighborhoods using Canadian postal codes. SES was defined primarily based on education attained, household income, employment and housing security. The top 20 postal codes with the highest avoidable ED visits were categorized into quartiles and analyzed for trends using chi-squared tests of spatial association and Spearman rank correlations. Results: A consistent ordinal trend across quartiles was observed throughout the study period, with quartile 1 representing the lowest avoidable ED visits and quartile 4 the highest. The quartiles were unevenly distributed spatially, though there was a significant association between close proximity to the ED and avoidable visits (X2 = 7.07, p

Suggested Citation

  • Ryan P Strum & Brent McLeod & Andrew P Costa & Shawn Mondoux, 2024. "Neighborhood socioeconomic factors and characteristics correlated with avoidable emergency department visits: A spatial analysis of a Canadian academic hospital," PLOS ONE, Public Library of Science, vol. 19(10), pages 1-12, October.
    • Handle: RePEc:plo:pone00:0311575
    DOI: 10.1371/journal.pone.0311575
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    1. Sarah Mantwill & Silvia Monestel-Umaña & Peter J Schulz, 2015. "The Relationship between Health Literacy and Health Disparities: A Systematic Review," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-22, December.
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