BACKGROUND: Little has been written about the geographic basis of emergency department (ED) visits. OBJECTIVE: The objective of this study is to describe the impact of geography on ED visits. METHODS: A retrospective analysis was conducted of ED visits during a 1-year period at a single institution using spatial interaction analysis that models the pattern of flow between a series of origins (census block groups) and a destination (ED). Patients were assigned to census block groups based upon their verified home address. The study hospital is the only Level I trauma, pediatric, and tertiary referral center in the area. There are 11 other hospitals with EDs within a 40-mile radius. Each patient visit within this radius, including repeat visits, was included. Patients with an invalid home address, a post office box address, or those who lived outside a 40-mile radius were excluded. ED visits per 100 population were calculated for each census block group. RESULTS: There were 98,584 (95%) visits by 63,524 patients that met study inclusion criteria. Visit rates decreased with increasing distance from the ED (p < 0.0001). Nineteen percent of patients lived within 2 miles, 48% within 4 miles, and 92% within 12 miles of the ED. The Connecticut border, 7 miles south of the ED (p < 0.0001), the Connecticut River, 1 mile west of the ED (p < 0.0001), and the presence of a competing ED within 1 mile (p < 0.0001) negatively impacted block group ED visit rates. Travel distance was related to the percentage of visits that were high acuity (p < 0.0001), daytime (p < 0.01), or resulted in admission (p < 0.0001). CONCLUSIONS: Geography and travel distance significantly impact ED visits.
BACKGROUND: Little has been written about the geographic basis of emergency department (ED) visits. OBJECTIVE: The objective of this study is to describe the impact of geography on ED visits. METHODS: A retrospective analysis was conducted of ED visits during a 1-year period at a single institution using spatial interaction analysis that models the pattern of flow between a series of origins (census block groups) and a destination (ED). Patients were assigned to census block groups based upon their verified home address. The study hospital is the only Level I trauma, pediatric, and tertiary referral center in the area. There are 11 other hospitals with EDs within a 40-mile radius. Each patient visit within this radius, including repeat visits, was included. Patients with an invalid home address, a post office box address, or those who lived outside a 40-mile radius were excluded. ED visits per 100 population were calculated for each census block group. RESULTS: There were 98,584 (95%) visits by 63,524 patients that met study inclusion criteria. Visit rates decreased with increasing distance from the ED (p < 0.0001). Nineteen percent of patients lived within 2 miles, 48% within 4 miles, and 92% within 12 miles of the ED. The Connecticut border, 7 miles south of the ED (p < 0.0001), the Connecticut River, 1 mile west of the ED (p < 0.0001), and the presence of a competing ED within 1 mile (p < 0.0001) negatively impacted block group ED visit rates. Travel distance was related to the percentage of visits that were high acuity (p < 0.0001), daytime (p < 0.01), or resulted in admission (p < 0.0001). CONCLUSIONS: Geography and travel distance significantly impact ED visits.
Authors: David C Lee; Brendan G Carr; Tony E Smith; Van C Tran; Daniel Polsky; Charles C Branas Journal: Popul Health Manag Date: 2015-02-06 Impact factor: 2.459
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Authors: Gavin M Rudge; Mohammed A Mohammed; Sally C Fillingham; Alan Girling; Khesh Sidhu; Andrew J Stevens Journal: PLoS One Date: 2013-07-16 Impact factor: 3.240
Authors: David J Wallace; Derek C Angus; Christopher W Seymour; Donald M Yealy; Brendan G Carr; Kristen Kurland; Arthur Boujoukos; Jeremy M Kahn Journal: PLoS One Date: 2014-04-04 Impact factor: 3.240
Authors: Nitish Patidar; Robert Weech-Maldonado; Stephen J O'Connor; Bisakha Sen; Jerry M Trimm; Carlos A Camargo Journal: Inquiry Date: 2017-01-01 Impact factor: 1.730