Is the use of emergency departments socially patterned?

Int J Public Health. 2018 Apr;63(3):397-407. doi: 10.1007/s00038-017-1073-3. Epub 2018 Jan 13.

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.

Keywords: Administrative database; Emergency department; Primary access to care; Social inequalities in health.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Emergency Service, Hospital / statistics & numerical data*
  • Ethnicity
  • Female
  • France
  • Health Status Disparities
  • Humans
  • Male
  • Middle Aged
  • Residence Characteristics
  • Socioeconomic Factors*
  • United States
  • Young Adult