Description
The purpose of this study was to assess the relationship between predisposing, enabling, and need factors and ED admission, in accordance with Andersen’s Behavioral Model. The study was also designed to examine the relationship between Medicaid health insurance and emergency department admission, prior to Medicaid’s expansion. By furthering our understanding of the factors that may make an individual more likely to be admitted through the ED, we may be able to draw conclusions about individuals with frequent ED admissions and find ways to better meet their needs in the future. This study was conducted by a doing multivariate analysis adjusting for the predisposing, enabling and need factors in Andersen’s model. The 2010 data was taken from an inpatient survey called the National Hospital Discharge Survey prior to the implementation of the ACA. The majority of the results in this study supported the hypotheses. The variables with the strongest association with ED admission were being of older age and being a self-pay patient. In addition, when all factors were controlled for, there was a significant association between having Medicaid coverage and being admitted to the hospital through the ED. Although the bivariate analysis indicated that patients who had Medicaid were less likely to be admitted through the ED, the multivariate analysis showed that when adjusting for other variables, patients who had Medicaid were more likely to be admitted to the hospital through the ED. Thus, Medicaid patients may experience barriers in regard to their ability to receive access to timely care prior to being admitted. Since the study found a relationship between Medicaid insurance and ED admission, healthcare professionals must advocate to ensure that barriers do not continue to increase ED rates and the nation’s spending on healthcare. Age was found to have the greatest association with ED admission in this study. Further research should be done to examine potential overuse or misuse of the ED by older adults, and to determine how inappropriate ED use can be mitigated. Research should also address older adults’ ability to receive timely care and whether improved access to care could help decrease ED admissions.
