Exploring medical utilization patterns of emergency department users.

BACKGROUND/PURPOSE: The intercategory relationship of various medical services is of importance to both health care management and policy-making. The purpose of this study was to explore the intercategory relationship of emergency medical services and other medical services and to examine the medical utilization patterns of emergency department (ED) users.

METHODS

The sample was selected from the National Health Insurance Research Database in Taiwan for the year 2004. A total of 6775 patients who visited the ED were included. Multiple logistic regression analyses were performed to determine relationships between emergency medical services and other medical services, and cluster analysis characterized different medical utilization patterns of ED users.

RESULTS

Frequent ED users (>or= 4 ED visits during the year) were more likely to use other health care services: their odds ratios (ORs) were 10.30 (95% confidence interval [CI], 7.53-14.10) for 11 or more visits to hospital outpatient departments, 1.51 (95% CI, 1.14-1.99) for 13 or more visits to primary care physicians, and 4.90 (95% CI, 3.74-6.43) for in-hospital care. Moreover, ED users fell into four medical utilization patterns: low health care users (61.91%), hospital fans (11.93%), primary care favorers (21.21%) and high health care users (4.95%).

CONCLUSION

Frequent ED users also heavily used other health care services. ED users have different utilization patterns, which is a reflection of the unique needs for various health care services. Such knowledge is critically important for both health care providers and policy-makers who must meet the needs of different patient groups.