After-hours access to ambulatory care on Sunday and utilization of emergency department for loyal patient
Journal
Taiwan Journal of Public Health
Journal Volume
39
Journal Issue
6
Date Issued
2020-12-01
Author(s)
Tsai, Chin Ling
Abstract
Objectives: Barriers to timely access to usual sources of medical care lead patients to use the emergency department as a ready alternative. This study aims to determine the characteristics of patients who use medical resources on Sundays. We also examined the relationship between emergency department visits and barriers to receiving sual sources of care in a timely manner for loyal patients. Methods: Data from 2016 to 2018 were obtained from Taiwan's National Health Insurance Research Database, and the study estimated of medical care utilization in the past year. Patients were classified as having a usual source of care if they made 80% or more of their total ambulatory visits to the same clinic. Descriptive statistics and logistic regression analyses were used to determine relationships between the medical service provided on Sundays and the use of the emergency department by loyal patients. Results: This study included 2,952,002 ambulatory and emergency department visits from 1,449,968 loyal patients. Patients who had a higher risk of emergency visits had the following characteristics: Male, over 65 years of age, low-income, co-morbidities, major injuries, poor physical health, or poor mental health. In terms of medical use, the following was also associated with a higher risk of emergency visits by patients: Low outpatient visits, having a record of hospitalization in the past year, after-hours visits, medical needs for surgery, or pediatrics. The positive associations between barriers to receiving usual source of care in a timely manner and emergency department usage persisted even in multiple logistic regressions that adjusted for patient characteristics, medical use, and characteristics of medical institutions. The risk of emergency department visits was significantly higher among loyalpatients whose usual clinics did not provide medical services that met their needs than among patients whose usual clinics did meet their needs (OR=12.72, 95%CI: 12.56-12.87). Conclusions: The results indicate that loyal patients who have barriers to their usual source of medical care are more likely to utilize the emergency department. Improving the availability and accessibility of primary medical care on Sundays may help reduce rates of emergency department use and resolve current situations of unmet medical needs.
Subjects
After-Hours Visit | Emergency Visit | Loyal Patients | Usual Source Of Care
SDGs
Type
journal article