Characteristics of Medicaid Enrollees with Frequent ED Use

An elderly man wheels his wheelchair bound wife away from a hospital emergency wing.

Medicaid enrollees, frequent users of ED, account for 38 percent of all ED visits.

The Issue:
Frequent ED users often seek care for conditions that could be treated by a primary care provider, however these patients often suffer from barriers in accessing care. 

This study examined the differences in sociodemographic and clinical characteristics and evaluated them based on frequency of ED use (4-6, 7-17, and ≥18 ED visits in one year).

Key Findings

  • Overall, 67 percent had a primary care provider, and 56 percent had one or more chronic diseases.

  • Patients with ≥18 visits per year were more likely to be homeless; suffer from alcohol abuse; and not have a primary care provider.

  • The most common diagnosis among patients with 4-6 visits was abdominal pain, while among patients with 7-17 or ≥18 visits, the most common diagnosis was alcohol-related disorders.

Conclusion:
Efforts to reduce frequent ED use among Medicaid enrollees require more than just ensuring access to a primary care provider; complex social needs must be addressed as many suffer homelessness and alcohol abuse. This study shows that patient characteristics differed by number of ED visits and efforts to reduce frequent ED users should be tailored accordingly. This was a single-center, retrospective study and some data may have been underestimated.

About the Study:
Using a retrospective chart review from January 2011 through December 2011, this study examined a population of Medicaid enrollees with frequent ED visits to an urban hospital within one year.