Socioeconomic and job-related determinants of emergency department use

Abstract

The current study examined the relationship between job status as well as socioeconomic factors and use of an emergency department (ED) over other sources of care. The study also sought to identify any other confounding variables in this choice of care location such as age, gender, insurance status, or reason for not working. Methods: A secondary analysis of the National Health Interview Survey (NHIS) data was conducted for years 2010-2012 to determine the relationship between job or socioeconomic status and the use of an ED. Binary logistic regression models were performed and many potentially confounding factors were included to determine whether or not the relationship remains despite these other variables. Results: Definite changes in the use of EDs over other sources of care exist between those of differing job status or socioeconomic status. Those making below 150% of the federal poverty level (FPL) are more likely to use an ED ([italic B]= 2.85, p < 0.001) compared to those who earn over 500% of the FPL, and the likelihood of using an ED decreases steadily as the ratio of income to the FPL increases. This change is also seen in education, where the less educated are more likely to use an ED than the more educated. Lastly, those who are working are less likely to use an ED than those who claim to be currently looking for work ([italic B]= 0.00 vs 1.62, p < 0.001) when compared to those who are not working or looking for work. The findings may be used to better identify the despaired population and reduce the burden currently felt on EDs.