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The Association Between Office-Based Provider Visits and Emergency Department Utilization Among Medicaid Beneficiaries

Journal of Community Health volume 40, pages 549–554 (2015)Cite this article

Abstract

The purpose of our study was to describe the relationship between office-based provider visits and emergency department (ED) utilization by adult Medicaid beneficiaries. Data were extracted from the publicly-available Medical Expenditure Panel Survey, a nationally representative sample of the civilian non-institutionalized population in the United States. The sample included 1,497 respondents who had full year Medicaid coverage in 2009. Study variables included insurance coverage type, usual source of care, chronic illnesses, and beneficiary demographics. Multivariate analyses were conducted to describe associations between individual characteristics and (a) likelihood of any ED utilization, and (b) number of ED visits by those who utilized the ED at least once in the study year. The analysis was adjusted for demographic characteristics and chronic health conditions. A greater number of office-based provider visits was associated with a higher likelihood of ED utilization. Among those with at least one ED visit, a greater number of office-based visits was associated with a higher number of ED visits. A respondent’s age, history of hypertension or myocardial infarction, and Hispanic/Latino ethnicity were associated with having one or more ED visits; age and Hispanic/Latino ethnicity were associated with total number of ED visits among those with at least one. In this representative sample of adult Medicaid beneficiaries, there was no evidence that office-based provider visits reduced ED utilization. Office visits were associated with higher ED utilization, as were certain chronic conditions, older age, and Hispanic/Latino ethnicity. Findings do not support efforts to reduce ED utilization by increasing office-based visits alone.

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Conflict of interest

The authors have no conflicts of interest to disclose.

Author information

Affiliations

  1. Texas A&M Health Science Center College of Medicine, 2401 South 31st Street, Temple, TX, 76508, USA

    Andrew J. Widmer

  2. Department of Internal Medicine, Baylor Scott & White Health, 2401 South 31st Street, Temple, TX, 76508, USA

    Rashmita Basu

  3. Baylor Scott & White Health System Quality and Safety, Baylor Scott & White Health, 2401 South 31st Street, Temple, TX, 76508, USA

    Angela K. Hochhalter

Authors
  1. Andrew J. Widmer
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  2. Rashmita Basu
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  3. Angela K. Hochhalter
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Correspondence to Andrew J. Widmer.

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Widmer, A.J., Basu, R. & Hochhalter, A.K. The Association Between Office-Based Provider Visits and Emergency Department Utilization Among Medicaid Beneficiaries. J Community Health 40, 549–554 (2015). https://doi.org/10.1007/s10900-014-9970-3

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  • DOI: https://doi.org/10.1007/s10900-014-9970-3

Keywords

  • Emergency department utilization
  • Medicaid beneficiaries
  • Office-based provider visits