New Report Highlights ED Use In West Queens
By MEGAN MONTALVO
On Sept. 10, the United Hospital Fund released a new report that gave an in-depth look at the patterns of emergency department utilization in New York City hospitals.
The report, entitled “Time and Again: Frequent Users of Emergency Department Services in New York City,” is one of the first to study patterns of New York City emergency department use at an individual level.
Designed to aid in the reshaping of health care services, “Time and Again” examines the characteristics between frequent users — those who made three or more emergency department visits in a year — and super-users, who made five or more visits each year from 2006 to 2008.
It also focused on the considerable variation in emergency department use by neighborhood.
At an overall Citywide level, the report showed 22 percent of the population made at least one “treat and release” visit in 2008. However, when broken down by neighborhood, ED utilization varied considerably, ranging from a low of 8 percent in the Upper East Side to a high of 41 percent in East Harlem.
According to the report, the level of ED use was strongly associated with neighborhood poverty, the proportion of uninsured residents, Blacks and Hispanics and residents’ reports of poor/fair health status, no regular doctor, and difficulty getting medical care when needed.
While neighborhoods in Queens had mostly below-average use compared to the Citywide average, the report found that when it came to children aged 0 to 4 years old, western Queens had the highest neighborhood rate. Almost one-quarter of all ED visits (23 percent) made in western Queens were made by children who were under 5-years-old.
These results led report authors Dr. Maria Raven and Dr. David Gould to suggest that interventions specific to the pediatric population and their caregivers, including a need for further study on the current pediatric ambulatory capacity.
“A complex interplay of factors shapes distinct patterns of use for neighborhoods, as well as for individuals,” Gould said. “It’s easy to think that adding a new primary care provider here or there will address a range of problems, but we must also pay careful attention to a range of other considerations, including individuals’ health status, socioeconomic circumstances, and care-seeking behaviors. All those factors must be addressed.”
In compiling the analysis of ED use, the report authors underscored the need for system reform. The data led the team to suggest that a creation of well-structured primary care services in addition to adding support mechanisms, such as a 24-hour call-in service, to help people to change long-held perception that the ED is the easier place to get a full range of services.
To view the “Time and Again” report in full, visit www.uhfnyc.org.
Reach Reporter Megan Montalvo at (718) 357-7400 Ext. 128 or mmontalvo@ queenstribune.com.