Hélène Colineaux1,2, Fanny Le Querrec3, Laure Pourcel3, Jean-Christophe Gallart3,4, Olivier Azéma3, Thierry Lang5,6, Michelle Kelly-Irving6, Sandrine Charpentier6,4, Sébastien Lamy6,7. 1. Department of Epidemiology, Health Economics and Public Health, Toulouse University Hospital, 37, Allées Jules Guesde, 31000, Toulouse, France. ln.colineaux@gmail.com. 2. LEASP UMR1027, INSERM-Université Toulouse III, 31000, Toulouse, France. ln.colineaux@gmail.com. 3. Regional Observatory of Emergency Medicine in the Midi-Pyrénées (ORU-MiP), 31000, Toulouse, France. 4. Emergency Department, Toulouse University Hospital, 31000, Toulouse, France. 5. Department of Epidemiology, Health Economics and Public Health, Toulouse University Hospital, 37, Allées Jules Guesde, 31000, Toulouse, France. 6. LEASP UMR1027, INSERM-Université Toulouse III, 31000, Toulouse, France. 7. Department of Clinical Pharmacology, Toulouse University Hospital, 31000, Toulouse, France.
Abstract
OBJECTIVES: To analyse the association between patients' socioeconomic position (SEP) and the use of emergency departments (EDs). METHODS: This population-based study included all visits to ED in 2012 by inhabitants of the French Midi-Pyrénées region, recorded by the Regional Emergency Departments Observatory. We compared ED visit rates and the proportion of non-severe visits according to the patients' SEP as assessed by the European Deprivation Index. RESULTS: We analysed 496,388 visits. The annual ED visit rate increased with deprivation level: 165.9 [95% CI (164.8-166.9)] visits per 1000 inhabitants among the most advantaged group, compared to 321.9 [95% CI (320.3-323.5)] per 1000 among the most disadvantaged. However, the proportion of non-severe visits was about 14% of the visits, and this proportion did not differ according to SEP. CONCLUSIONS: Although the study shows a difference of ED visit rates, the probability of a visit being non-severe is not meaningfully different according to SEP. This supports the assumption that ED visit rate variations according to SEP are mainly explained by SEP-related differences in health states rather than SEP-related differences in health behaviours.
OBJECTIVES: To analyse the association between patients' socioeconomic position (SEP) and the use of emergency departments (EDs). METHODS: This population-based study included all visits to ED in 2012 by inhabitants of the French Midi-Pyrénées region, recorded by the Regional Emergency Departments Observatory. We compared ED visit rates and the proportion of non-severe visits according to the patients' SEP as assessed by the European Deprivation Index. RESULTS: We analysed 496,388 visits. The annual ED visit rate increased with deprivation level: 165.9 [95% CI (164.8-166.9)] visits per 1000 inhabitants among the most advantaged group, compared to 321.9 [95% CI (320.3-323.5)] per 1000 among the most disadvantaged. However, the proportion of non-severe visits was about 14% of the visits, and this proportion did not differ according to SEP. CONCLUSIONS: Although the study shows a difference of ED visit rates, the probability of a visit being non-severe is not meaningfully different according to SEP. This supports the assumption that ED visit rate variations according to SEP are mainly explained by SEP-related differences in health states rather than SEP-related differences in health behaviours.
Entities:
Keywords:
Administrative database; Emergency department; Primary access to care; Social inequalities in health
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