Impact of socioeconomic variables on Emergency Department visits : An analysis of New Jersey zip codes using New Jersey State Emergency Department discharge data from 2005 to 2008

Barriers to primary care often result in patients presenting in Emergency Departments and using the ED as their main source of care. This study is intended to confirm this notion by examining the impact of seven selected socioeconomic barriers on ED visit rates through an analysis of New Jersey Zip Codes. Of the 551 Zip Codes in which population data were reported, the rates of poverty, unemployment, education, linguistic isolation, black, Hispanic, rental population, Ambulatory Care Sensitive Conditions (ACSC) and non ACSC ED visits were identified for the analysis. The results show that all the seven socioeconomic variables were significantly correlated to both ACSC and non ACSC rates. Of the seven variables, poverty had the highest correlation with ACSC(r= .79,p<0.0001) and non ACSC (r=.69,p<0.0001) rates, and regression analysis shows that poverty was the strongest predictor of both ACSC and non ACSC. Education was the second most important predictor of both ACSC and non ACSC rates, but its impact was greater on non ACSC rates. Poverty, unemployment, education, linguistic isolation, black, and rental population rates successfully explained 73% of ACSC rates. In the modeling of non ACSC visit rates, black and Hispanic rates were dropped, and the remaining variables explained 62% of non ACSC rates. The findings confirm the notion that EDs are used as the source of primary care for the population characterized by lower socioeconomic status, and further found the impact of selected socioeconomic variables is stronger on ACSC than non ACSC ED visit rates in New Jersey.