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The effect of the doctor-patient relationship on emergency department use among the elderly.
- Source :
-
American journal of public health [Am J Public Health] 2000 Jan; Vol. 90 (1), pp. 97-102. - Publication Year :
- 2000
-
Abstract
- Objectives: This study sought to determine the rate of emergency department use among the elderly and examined whether that use is reduced if the patient has a principal-care physician.<br />Methods: The Health Care Financing Administration's National Claims History File was used to study emergency department use by Medicare patients older than 65 years in Washington State during 1994.<br />Results: A total of 18.1% of patients had 1 or more emergency department visits during the study year; the rate increased with age and illness severity. Patients with principal-care physicians were much less likely to use the emergency department for every category of disease severity. After case mix, Medicaid eligibility, and rural/urban residence were controlled for, the odds ratio for having any emergency department visit was 0.47 for patients with a generalist principal-care physician and 0.58 for patients with a specialist principal-care physician.<br />Conclusions: The rate of emergency department use among the elderly is substantial, and most visits are for serious medical problems. The presence of a continuous relationship with a physician--regardless of specialty--may reduce emergency department use.
- Subjects :
- Aged
Aged, 80 and over
Diagnosis-Related Groups
Family Practice
Female
Humans
Logistic Models
Male
Medicine
Odds Ratio
Severity of Illness Index
Specialization
Washington
Emergency Service, Hospital statistics & numerical data
Health Services Misuse statistics & numerical data
Physician-Patient Relations
Subjects
Details
- Language :
- English
- ISSN :
- 0090-0036
- Volume :
- 90
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- American journal of public health
- Publication Type :
- Academic Journal
- Accession number :
- 10630144
- Full Text :
- https://doi.org/10.2105/ajph.90.1.97