Inpatient and emergency department utilization: the effect of distance, social class, age, sex, and marital status.

This study attempted to measure whether patients using two hospital services -- inpatient facilities and the emergency department -- were representative of the population. It sought to confirm the assumptions that, if patient demands were uniform and there were no barriers to emergency department use: (1) emergency patients would closely represent the population in the geographic service area of the hospital, and (2) factors such as distance from residence, age, marital status, social class, and sex, would be relatively uniform between inpatients and emergency patients. The first assumption was supported by the results of the study. Concerning the second, the 0- to 19-year-old group had a high emergency department utilization and low utilization of inpatient facilities when 35- to 65-year-old group had a lower emergency department and a higher inpatient usage pattern. The 65-year-old and over group had two and one-half times as many inpatient admissions as their number in the general service area would suggest. More men than women used the emergency department. Separated and divorced people were heavy users of the emergency department whereas widows heavily used inpatient facilities. Social class was not found to be significantly different among those using the inpatient service or emergency department.