Frequent Emergency Department Users: Focusing Solely On Medical Utilization Misses The Whole Person
Frequent Emergency Department Users: Focusing Solely On Medical Utilization Misses The Whole Person
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DOI：
10.1377/hlthaff.2019.00082
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发表时间：
2019-11-01
期刊：
影响因子：
9.7
通讯作者：
Raven, Maria C.
中科院分区：
文献类型：
--
作者：
Kanzaria, Hemal K.;Niedzwiecki, Matthew;Raven, Maria C.
频繁的急诊科（艾德）用户通常有复杂的行为健康和社会需求。然而，政策制定者往往把重点放在这一人群的医疗系统的使用，而不检查其使用的行为健康和社会服务系统。为了阐明频繁艾德用户的广泛需求，我们比较了加州州弗朗西斯科县非老年人非频繁，频繁和超频繁艾德用户的医疗，心理健康，物质使用和社会服务使用。我们将2013-15财政年度该县医疗补助管理式医疗计划受益人的行政数据与县级综合数据系统相关联。与非频繁使用者相比，频繁使用者中女性、白色或非裔美国人/黑人和无家可归者比例过高。他们有更多的合并症和年度门诊心理健康访问（11.93对4.16），精神病住院（0.73对0.07），清醒中心访问（0.17对0.07）。
Frequent emergency department (ED) users often have complex behavioral health and social needs. However, policy makers often focus on this population's medical system use without examining its use of behavioral health and social services systems. To illuminate the wide-ranging needs of frequent ED users, we compared medical, mental health, substance use, and social services use among nonelderly nonfrequent, frequent, and superfrequent ED users in San Francisco County, California. We linked administrative data for fiscal years 2013-15 for beneficiaries of the county's Medicaid managed care plan to a county-level integrated data system. Compared to nonfrequent users, frequent users were disproportionately female, white or African American/black, and homeless. They had more comorbidities and annual outpatient mental health visits (11.93 versus 4.16), psychiatric admissions (0.73 versus 0.07), and sobering center visits (0.17 versus