OBJECTIVES: To quantify dynamic availability of ambulatory care, and to examine possible associations with non-emergency treatments in emergency departments (EDs). METHODS: Longitudinal data from the Taiwan National health Insurance Research Database were used to evaluate 749,584 emergency-medicine cases occurring between 2005 and 2010 according to a modified New York University algorithm. Multivariable-cumulative-logistic-regression analysis with generalized estimating-equation methods was used to determine associations between availability of ambulatory care and the urgency of patients' medical needs during ED visits. RESULTS: More than half (53.04%) of the ED visits that were evaluated in our study were classified as non-emergencies, and over half of these occurred despite a high availability of ambulatory care facilities (median > 96%). Compared with patients in areas with a low availability of ambulatory care, patients in areas of medium to high availability showed approximately 0.8 times lower odds ratios for associations with non-emergency ED visits. CONCLUSIONS: Non-emergency ED visits may be reduced by increasing the availability of ambulatory care facilities in areas with deficits in the availability of such facilities. However, increasing the availability of ambulatory care by raising the number of available ambulatory care physicians or the number of ambulatory care facilities may not reduce non-emergency ED visits in areas with medium to high availability of ambulatory care facilities.
OBJECTIVES: To quantify dynamic availability of ambulatory care, and to examine possible associations with non-emergency treatments in emergency departments (EDs). METHODS: Longitudinal data from the Taiwan National health Insurance Research Database were used to evaluate 749,584 emergency-medicine cases occurring between 2005 and 2010 according to a modified New York University algorithm. Multivariable-cumulative-logistic-regression analysis with generalized estimating-equation methods was used to determine associations between availability of ambulatory care and the urgency of patients' medical needs during ED visits. RESULTS: More than half (53.04%) of the ED visits that were evaluated in our study were classified as non-emergencies, and over half of these occurred despite a high availability of ambulatory care facilities (median > 96%). Compared with patients in areas with a low availability of ambulatory care, patients in areas of medium to high availability showed approximately 0.8 times lower odds ratios for associations with non-emergency ED visits. CONCLUSIONS: Non-emergency ED visits may be reduced by increasing the availability of ambulatory care facilities in areas with deficits in the availability of such facilities. However, increasing the availability of ambulatory care by raising the number of available ambulatory care physicians or the number of ambulatory care facilities may not reduce non-emergency ED visits in areas with medium to high availability of ambulatory care facilities.
Authors: Paul Harris; Jennifer A Whitty; Elizabeth Kendall; Julie Ratcliffe; Andrew Wilson; Peter Littlejohns; Paul A Scuffham Journal: BMJ Open Date: 2015-04-03 Impact factor: 2.692
Authors: Ting-Ying Chien; Hsien-Wei Ting; Chien-Lung Chan; Nan-Ping Yang; Ren-Hao Pan; K Robert Lai; Su-In Hung Journal: Int J Environ Res Public Health Date: 2017-12-10 Impact factor: 3.390
Authors: Liang-Chung Huang; Wu-Fu Chung; Shih-Wei Liu; Jau-Ching Wu; Li-Fu Chen; Yu-Chun Chen Journal: Int J Environ Res Public Health Date: 2019-06-05 Impact factor: 3.390