Characteristics of Non-Emergent Visits in Emergency Departments: Profiles and Longitudinal Pattern Changes in Taiwan, 2000–2010

Liang-Chung Huang, Wu-Fu Chung, Shih-Wei Liu, Jau-Ching Wu, Li-Fu Chen and Yu-Chun Chen
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Liang-Chung Huang: Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 26042, Taiwan
Wu-Fu Chung: Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 26042, Taiwan
Shih-Wei Liu: Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 26042, Taiwan
Jau-Ching Wu: School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
Li-Fu Chen: Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 26042, Taiwan
Yu-Chun Chen: School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan

IJERPH, 2019, vol. 16, issue 11, 1-16

Abstract: An increasing number of emergency department (ED) visits have posed a challenge to health systems in many countries, but an understanding of non-emergent ED visits has remained limited and contentious. This retrospective study analyzed ED visits using three representative cohorts from routine data to explore the profiles and longitudinal pattern changes of non-emergent ED visits in Taiwan. Systematic-, personal-, and ED visit-level data were analyzed using a logistic regression model. Average marginal effects were calculated to compare the effects of each factor. The annual ED visit rate increased up to 261.3 per 1000 population in 2010, and a significant one-third of visits were considered as non-emergent. The rapidly growing utilization of ED visits underwent a watershed change after cost-sharing payments between patients and medical institutions were increased in 2005. In addition to cohort effects resulting from cost-sharing payment changes, all factors were significantly associated with non-emergent ED visits with different levels of impact. We concluded that non-emergent ED visits were associated with multifaceted factors, but the change to cost-sharing payment, being female, younger age, and geographical residence were the most predictive factors. This information would enhance the implementation of evidence-based strategies to optimize ED use.

Keywords: emergent department (ED); non-emergent ED visits; cohort effect; health utilization (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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