Predictors of Emergency Department Use among Individuals with Current or Previous Experience of Homelessness

This study assessed the contributions of predisposing, enabling, and needs factors in predicting emergency department (ED) use among 270 individuals with current or previous experience of homelessness. Participants were recruited from three different types of housing (shelter, temporary housing and permanent housing) in Montreal, Quebec (Canada). They were interviewed at baseline (T0), and again 12 months after recruitment (T1). Longitudinal data analyses were conducted on associations between a set of baseline predictors (T0) with the dependent variable (ED users vs. non-users) from T1. Predictors were identified according to the Gelberg–Andersen Behavioral Model. Findings revealed two needs factors associated with ED use: having a substance use disorder (SUD) and low perceived physical health. Two enabling factors, use of ambulatory specialized services and stigma, were also related to ED use. No predisposing factors were retained in the model, and ED use was not associated with type of housing. Improvements are needed in SUD and physical health management in order to reduce ED use, as well as interventions aimed at stigma prevention for this vulnerable population.

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Factors Influencing Patients Using Long-Term Care Service of Discharge Planning by Andersen Behavioral Model: A Hospital-Based Cross-Sectional Study in Eastern Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062949 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2949

Author(s):

Yi-Chien Chen ◽

Wei-Ting Chang ◽

Chin-Yu Huang ◽

Peng-Lin Tseng ◽

Chao-Hsien Lee

Keyword(s):

Long Term Care ◽

Discharge Planning ◽

Care Service ◽

Behavioral Model ◽

Planning Service ◽

Enabling Factors ◽

Cross Sectional ◽

Term Care ◽

Andersen Behavioral Model

Taiwan has been an aged society since March 2018, and the elderly population suffer from multiple comorbidities and long duration of disability. Therefore, the service of discharge planning of long-term care 2.0 is an important stage before patients go back to the community. Strengthening the sensitivity when identifying predisabled patients is a principal development of discharge planning. In the current study, we analyzed the characteristics and predictive factors of patients who used the service of long-term care 2.0 from the perspective of discharge planning. In this retrospective study, we included patients who received the discharge planning service in a hospital located in southern Hualien during November 2017 to October 2018. The data were collected and classified as predisposing factors, enabling factors, and need factors according to the analysis architecture of the Andersen Behavioral Model. There were 280 valid patients included in this current study; age, medical accessibility, possession of a disability card, and cerebrovascular diseases, cardiovascular diseases, and diabetes mellitus were the vital factors which influenced the coherence and cohesion between discharge planning and the service of long-term care 2.0. Among them, the most influencing factor was age. We hope that the current study will make policymakers in hospitals pay attention to the usage of the discharge planning service to link long-term care 2.0 and effectively promote the usage of long-term care 2.0.

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Typology of patients who use emergency departments for mental and substance use disorders

BJPsych Open ◽

10.1192/bjo.2020.39 ◽

2020 ◽

Vol 6 (4) ◽

Cited By ~ 1

Author(s):

Marie-Josée Fleury ◽

Guy Grenier ◽

Jean-Marie Bamvita ◽

Francine Ferland

Keyword(s):

Mental Health ◽

Emergency Department ◽

Substance Use ◽

Mental Disorders ◽

Health Service ◽

Substance Use Disorders ◽

General Practitioners ◽

Emergency Departments ◽

Enabling Factors ◽

Emergency Department Use

Background Identifying profiles of people with mental and substance use disorders who use emergency departments may help guide the development of interventions more appropriate to their particular characteristics and needs. Aims To develop a typology for the frequency of visits to the emergency department for mental health reasons based on the Andersen model. Method Questionnaires were completed by patients who attended an emergency department (n = 320), recruited in Quebec (Canada), and administrative data were obtained related to sociodemographic/socioeconomic characteristics, mental health diagnoses including alcohol and drug use, and emergency department and mental health service utilization. A cluster analysis was performed, identifying needs, predisposing and enabling factors that differentiated subclasses of participants according to frequency of emergency department visits for mental health reasons. Results Four classes were identified. Class 1 comprised individuals with moderate emergency department use and low use of other health services; mostly young, economically disadvantaged males with substance use disorders. Class 2 comprised individuals with high emergency department and specialized health service use, with multiple mental and substance use disorders. Class 3 comprised middle-aged, economically advantaged females with common mental disorders, who made moderate use of emergency departments but consulted general practitioners. Class 4 comprised older individuals with multiple chronic physical illnesses co-occurring with mental disorders, who made moderate use of the emergency department, but mainly consulted general practitioners. Conclusions The study found heterogeneity in emergency department use for mental health reasons, as each of the four classes represented distinct needs, predisposing and enabling factors. As such, interventions should be tailored to different classes of patients who use emergency departments, based on their characteristics.

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Greater access to primary care may reduce emergency department use

PsycEXTRA Dataset ◽

10.1037/e556202006-026 ◽

2005 ◽

Keyword(s):

Primary Care ◽

Emergency Department ◽

Emergency Department Use ◽

Access To Primary Care

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Emergency department use by oldest-old patients from 2005 to 2010 in a Swiss university hospital

BMC Health Services Research ◽

10.1186/1472-6963-13-344 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 23

Author(s):

Sarah Vilpert ◽

Hélène Jaccard Ruedin ◽

Lionel Trueb ◽

Stéfanie Monod-Zorzi ◽

Bertrand Yersin ◽

...

Keyword(s):

Emergency Department ◽

Oldest Old ◽

University Hospital ◽

Emergency Department Use ◽

Old Patients

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Injuries and frequent use of emergency department services: a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-040272 ◽

2020 ◽

Vol 10 (12) ◽

pp. e040272

Author(s):

Catherine Laferté ◽

Andréa Dépelteau ◽

Catherine Hudon

Keyword(s):

Systematic Review ◽

Emergency Department ◽

Cohort Studies ◽

Eligibility Criteria ◽

Geriatric Population ◽

Physical Injuries ◽

Frequent Use ◽

Different Types ◽

Ed Visits ◽

Return Visits

ObjectiveTo review all studies having examined the association between patients with physical injuries and frequent emergency department (ED) attendance or return visits.DesignSystematic review.Data sourceMedline, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO databases were searched up to and including July 2019.Eligibility criteriaEnglish and French language publications reporting on frequent use of ED services (frequent attendance and return visits), evaluating injured patients and using regression analysis.Data extraction and synthesisTwo independent reviewers screened the search results, and assessed methodological quality using the Joanna Briggs Institute tool for prevalence studies. Results were collated and summarised using a narrative synthesis. A sensitivity analysis was performed to evaluate the repercussions of removing a study that did not meet the quality criteria.ResultsOf the 2184 studies yielded by this search, 1957 remained after the removal of duplicates. Seventy-eight studies underwent full-text screening leaving nine that met the eligibility criteria and were included in this study: five retrospective cohort studies; two prospective cohort studies; one cross-sectional study; and one case-control study. Different types of injuries were represented, including fractures, trauma and physical injuries related to falls, domestic violence or accidents. Sample sizes ranged from 200 to 1 259 809. Six studies included a geriatric population while three addressed a younger population. Of the four studies evaluating the relationship between injuries and frequent ED use, three reported an association. Additionally, of the five studies in which the dependent variable was return ED visits, three articles identified a positive association with injuries.ConclusionsPhysical injuries appear to be associated with frequent use of ED services (frequent ED attendance as well as return ED visits). Further research into factors including relevant youth-related covariates such as substance abuse and different types of traumas should be undertaken to bridge the gap in understanding this association.

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Nonurgent Emergency Department Use During Pregnancy

Obstetrics and Gynecology ◽

10.1097/01.aog.0000447139.77554.a7 ◽

2014 ◽

Vol 123 ◽

pp. 150S ◽

Cited By ~ 2

Author(s):

Kimberly A. Kilfoyle ◽

Roxanne A. Vrees ◽

Kristen A. Matteson ◽

Maureen G. Phipps ◽

Christina A. Raker

Keyword(s):

Emergency Department ◽

Emergency Department Use

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Relating Activity and Participation Levels to Glycemic Control, Emergency Department Use, and Hospitalizations in Individuals With Type 2 Diabetes

Clinical Diabetes ◽

10.2337/cd17-0118 ◽

2018 ◽

Vol 36 (3) ◽

pp. 232-243

Author(s):

Matt P. Malcolm ◽

Karen E. Atler ◽

Arlene A. Schmid ◽

Tara C. Klinedinst ◽

Laura A. Grimm ◽

...

Keyword(s):

Type 2 Diabetes ◽

Emergency Department ◽

Glycemic Control ◽

Emergency Department Use

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The Effect of the Medicaid Expansion on Frequent Emergency Department Use in New York

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2021.07.003 ◽

2021 ◽

Author(s):

Theodoros V. Giannouchos ◽

Hye-Chung Kum ◽

Jodie Gary ◽

Robert Ohsfeldt ◽

Michael Morrisey

Keyword(s):

Emergency Department ◽

New York ◽

Medicaid Expansion ◽

Emergency Department Use

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Examining Dementia Family Caregivers’ Forgone Care for General Practitioners and Medical Specialists during a COVID-19 Lockdown

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073688 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3688

Author(s):

Perla Werner ◽

Aviad Tur-Sinai ◽

Hanan AboJabel

Keyword(s):

Family Caregivers ◽

Emotional Support ◽

Online Survey ◽

Behavioral Model ◽

Cross Sectional Study ◽

Enabling Factors ◽

Dementia Caregivers ◽

Predisposing Factor ◽

Cross Sectional ◽

Medical Specialists

The present study aimed to assess dementia caregivers’ reports of the prevalence and correlates of forgone care regarding visits to a general practitioner (GP) and to a specialist during the COVID-19 lockdown in Israel, using Andersen’s Behavioral Model of Healthcare Utilization. A cross-sectional study using an online survey was conducted with 73 Israeli family caregivers of persons with dementia residing in the community (81% Jews, 86% female, mean age = 54). Overall, one out of two participants reported having to delay seeking needed help from a GP or a specialist for themselves, as well as for their relatives with dementia, during the COVID-19 lockdown period. Among the predisposing factor, education was associated with caregivers’ reports regarding forgone care for themselves as well as for their loved ones. Living with the care-receiver and income level were the enabling factors associated with forgone care for caregivers. Finally, feelings of burden were associated with caregivers’ forgone care and feelings of loneliness and perceptions of the care-receiver’s cognitive functioning were associated with care-receivers’ forgone care. Our findings show that it is essential that this population receive appropriate practical and emotional support at times of distress and crisis to enable them to continue with their caregiving role.

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