Reasons for using the emergency department: Results of the EMPATH Study

Deborah Ragin, Ula Hwang, Rita K. Cydulka, Dave Holson, Leon L. Haley, Christopher F. Richards, Bruce M. Becker, Lynne D. Richardson

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Objectives: Emergency Medicine Patients' Access To Healthcare (EMPATH) was a cross-sectional, observational study conducted to identify the principal reasons why patients seek care in hospital emergency departments (EDs) in the United States. Methods: Twenty-eight U.S. hospitals, stratified by geographic region and hospital characteristics, participated in this study. Demographic, clinical, and insurance data were collected for a 24-hour period at each site, using chart reviews and a structured interview administered to all consenting adult patients seeking treatment during that period. Patients' reasons for presenting to the ED were assessed by their level of agreement (on a three-point Likert scale) with 21 carefully worded statements designed to capture a range of possible reasons for seeking care in the ED. Factor analysis was used to consolidate highly correlated responses and to identify the principal factors explaining patients' reasons for coming to the ED. Results: A total of 1,579 patient interviews and 2,004 chart reviews were obtained from a diverse sample that was 55.4% female, 58.3% white, 28.3% African American, 7.0% Hispanic, and 6.0% other ethnic groups. This exploratory analysis yielded five factors characterizing patients' principal reasons for seeking ED care, with medical necessity the most frequent, followed by ED preference, convenience, affordability, and limitations of insurance. Conclusions: Use of the ED is, for most people, an affirmative choice over other providers rather than a last resort; it is often a choice driven by lack of access to or dissatisfaction with other sources of care.

Original languageEnglish
Pages (from-to)1158-1166
Number of pages9
JournalAcademic Emergency Medicine
Volume12
Issue number12
DOIs
StatePublished - 1 Dec 2005

Fingerprint

Emergency Medicine
Hospital Emergency Service
Delivery of Health Care
Insurance
Interviews
Hospital Departments
Emergency Medical Services
Hispanic Americans
Ethnic Groups
African Americans
Statistical Factor Analysis
Observational Studies
Patient Care
Cross-Sectional Studies
Demography

Keywords

  • Access
  • Access to care
  • Emergency department
  • Emergency department utilization
  • Emergency department visits
  • Health services research

Cite this

Ragin, D., Hwang, U., Cydulka, R. K., Holson, D., Haley, L. L., Richards, C. F., ... Richardson, L. D. (2005). Reasons for using the emergency department: Results of the EMPATH Study. Academic Emergency Medicine, 12(12), 1158-1166. https://doi.org/10.1197/j.aem.2005.06.030
Ragin, Deborah ; Hwang, Ula ; Cydulka, Rita K. ; Holson, Dave ; Haley, Leon L. ; Richards, Christopher F. ; Becker, Bruce M. ; Richardson, Lynne D. / Reasons for using the emergency department : Results of the EMPATH Study. In: Academic Emergency Medicine. 2005 ; Vol. 12, No. 12. pp. 1158-1166.
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Ragin, D, Hwang, U, Cydulka, RK, Holson, D, Haley, LL, Richards, CF, Becker, BM & Richardson, LD 2005, 'Reasons for using the emergency department: Results of the EMPATH Study', Academic Emergency Medicine, vol. 12, no. 12, pp. 1158-1166. https://doi.org/10.1197/j.aem.2005.06.030

Reasons for using the emergency department : Results of the EMPATH Study. / Ragin, Deborah; Hwang, Ula; Cydulka, Rita K.; Holson, Dave; Haley, Leon L.; Richards, Christopher F.; Becker, Bruce M.; Richardson, Lynne D.

In: Academic Emergency Medicine, Vol. 12, No. 12, 01.12.2005, p. 1158-1166.

Research output: Contribution to journalArticle

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T1 - Reasons for using the emergency department

T2 - Results of the EMPATH Study

AU - Ragin, Deborah

AU - Hwang, Ula

AU - Cydulka, Rita K.

AU - Holson, Dave

AU - Haley, Leon L.

AU - Richards, Christopher F.

AU - Becker, Bruce M.

AU - Richardson, Lynne D.

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N2 - Objectives: Emergency Medicine Patients' Access To Healthcare (EMPATH) was a cross-sectional, observational study conducted to identify the principal reasons why patients seek care in hospital emergency departments (EDs) in the United States. Methods: Twenty-eight U.S. hospitals, stratified by geographic region and hospital characteristics, participated in this study. Demographic, clinical, and insurance data were collected for a 24-hour period at each site, using chart reviews and a structured interview administered to all consenting adult patients seeking treatment during that period. Patients' reasons for presenting to the ED were assessed by their level of agreement (on a three-point Likert scale) with 21 carefully worded statements designed to capture a range of possible reasons for seeking care in the ED. Factor analysis was used to consolidate highly correlated responses and to identify the principal factors explaining patients' reasons for coming to the ED. Results: A total of 1,579 patient interviews and 2,004 chart reviews were obtained from a diverse sample that was 55.4% female, 58.3% white, 28.3% African American, 7.0% Hispanic, and 6.0% other ethnic groups. This exploratory analysis yielded five factors characterizing patients' principal reasons for seeking ED care, with medical necessity the most frequent, followed by ED preference, convenience, affordability, and limitations of insurance. Conclusions: Use of the ED is, for most people, an affirmative choice over other providers rather than a last resort; it is often a choice driven by lack of access to or dissatisfaction with other sources of care.

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