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

Moira C. McManus, Robert J. Cramer, Maureen Boshier, Muge Akpinar-Elci and Bonnie Van Lunen
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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

IJERPH, 2018, vol. 15, issue 1, 1-15

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.

Keywords: emergency department; mental health; non-emergent care; Health Services Use; living location (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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