192512 Emergency department utilization for non-emergent conditions: An in-depth assessment of the decision calculus of patients at a major urban trauma center

Tuesday, November 10, 2009

Joshua George Behr, PhD , Virginia Modeling, Analysis and Simulation Center (VMASC), Old Dominion University, Norfolk, VA
Rafael Diaz, PhD , Virginia Modeling, Analysis and Simulation Center (VMASC), Old Dominion University, Norfolk, VA
This research presents the findings from a recent comprehensive study of patients engaged in inappropriate Emergency Department utilization at a major urban trauma center. Through the use of in-depth interviews of over 1,800 patients by researchers and medical doctors, this research has identified and measured the key factors considered in the decision calculus to seek services from the Emergency Department. Analysis reveals findings that confirm known trends but also challenge conventional wisdom about inappropriate utilization by the un- and under-insured as well as the insured. In addition, distinct patterns across socio-demographic, psychiatric, and pay classification groups are analyzed. The functionality of population-specific diversion interventions is discussed.

Learning Objectives:
List 12 key factors considered in a patient’s decision calculus when choosing to seek care from an emergency department. Differentiate among sub-populations the relative importance of structural barriers to emergency department utilization. Develop interventions designed to divert targeted sub-populations to primary care homes. Explain the competing goals of emergency department profitability and reduced patient congestion. Assess the level of inappropriate ED utilization by patients with previously unrecorded psychiatric conditions.

Keywords: Emergency Department/Room, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the project PI. The research was monitored by the IRB at three institutions: Eastern Virginia Medical School, Old Dominion University, and Sentara Health Systems. I am employed as a research professor within a research center at a Carnegie Extensive University. I hold a PhD from an accredited university. I have consulted/produced reports for local health officials/health departments. I have conducted extensive community health surveys and assessments in the region. I am the published author of one book and several peer reviewed journals articles.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.