NONURGENT EMERGENCY DEPARTMENT VISITS - THE EFFECT OF HAVING A REGULAR DOCTOR

OBJECTIVES. The authors assess the association between having a regula r doctor and presentation for nonurgent versus urgent emergency depart ment visits while controlling for potential confounders such as sociod emographics, health status, and comorbidity. METHODS. A cross-sectiona l study was conducted in emergency departments of five urban teaching hospitals in the northeast. Adult patients presenting with chest pain, abdominal pain, or asthma (n = 1696; 88% of eligible) were studied. P atients completed a survey on presentation, reporting sociodemographic s, health status, comorbid diseases, and relationship with a regular d octor. Urgency on presentation was assessed by chart review using expl icit criteria. RESULTS. Of the 1,696 study participants, 852 (50%) pre sented with nonurgent complaints. In logistic regression analyses, abs ence of a relationship with a regular physician was an independent cor relate of presentation for a nonurgent emergency department visit (odd s ratio 1.6; 95% confidence interval 1.2, 2.2) when controlling for ag e, gender, marital status, health status, and comorbid diseases. Race, lack of insurance, and education were not associated with nonurgent u se. CONCLUSIONS. Absence of a relationship with a regular doctor was c orrelated with use of the emergency department for selected nonurgent conditions when controlling for important potential confounders. Our s tudy suggests that maintaining a relationship with a regular physician may reduce nonurgent use of the emergency department regardless of in surance status or health status.