Unscheduled Care Access in the United States-A Tale of Two Emergency Departments
| Autor: | Arjun K. Venkatesh, Margaret B. Greenwood-Ericksen, Hao Mei, Zhenqiu Lin, Harlan M. Krumholz, Craig Rothenberg |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Rural Population medicine.medical_specialty Chronic condition Urban Population Referral Medicare Article Health Services Accessibility Health care Humans Medicine Aged Descriptive statistics business.industry Rural health General Medicine Emergency department United States Rural hospital Family medicine Utilization Review Emergency Medicine Female Rural area Emergency Service Hospital business |
| Zdroj: | Am J Emerg Med |
| ISSN: | 0735-6757 |
| Popis: | BACKGROUND: Rural communities face challenges in accessing healthcare services due to physician shortages and limited unscheduled care capabilities in office settings. As a result, rural hospital-based Emergency Departments (ED) may disproportionately provide acute, unscheduled care needs. We sought to examine differences in ED utilization and the relative role of the ED in providing access to unscheduled care between rural and urban communities. METHODS: Using a 20% sample of the 2012 Medicare Chronic Condition Warehouse, we studied the overall ED visit rate and the unscheduled care rate by geography using the Dartmouth Atlas’ hospital referral regions (HRR). We calculated HRR urbanicity as the proportion of beneficiaries residing in an urban zip code within each HRR. We report descriptive statistics and utilize K-means clustering based on the ED visit rates and unscheduled care rates. RESULTS: We found rural ED use is more common and disproportionately the site of unscheduled care delivery when compared to urban communities. The ED visit and unscheduled care proportions were negatively correlated with increased urbanicity (r = −0.48, p < 0.001; r = −0.58, p < 0.001). CONCLUSION: he use and role of EDs by Medicare beneficiaries appears to be substantially different between urban and rural areas. This suggests that the ED may play a distinct role within the healthcare delivery system of rural communities that face disproportionate barriers to care access. |
| Databáze: | OpenAIRE |
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