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Research ArticleResearch

Emergency department use

Is frequent use associated with a lack of primary care provider?

Erin Palmer, Denise Leblanc-Duchin, Joshua Murray and Paul Atkinson
Canadian Family Physician April 2014; 60 (4) e223-e229;
Erin Palmer
Department of Family Medicine at Dalhousie University in Saint John, NB.
MD CCFP
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Denise Leblanc-Duchin
Research Services at Horizon Health Network in New Brunswick.
PhD
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Joshua Murray
Research Services at Horizon Health Network in New Brunswick.
MSc
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Paul Atkinson
Department of Emergency Medicine at Dalhousie University.
MB BCh MA FCEM
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  • For correspondence: paul.atkinson@dal.ca
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    Figure 1.

    Total number of patients with and without registered PCPs who visited the URH, UCC, and RCH EDs during the 2009 calendar year

    ED—emergency department, PCP—primary care provider, RCH—rural community hospital, UCC—urgent care centre, URH—urban regional hospital.

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    Figure 2.

    Frequent ED attenders (4 or more visits in a year) at all sites with and without registered PCPs

    ED—emergency department, PCP—primary care provider.

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    Table 1.

    Patient characteristics from the 3 EDs

    CHARACTERISTICURH (N = 31 395), N (%)UCC (N = 26 230), N (%)RCH (N = 13 312), N (%)TOTAL* (N = 59 803), N (%)
    Total number of ED visits
      • 122 078 (70.3)18 143 (69.2)7303 (54.9)33 862 (56.6)
      • 2–37657 (24.4)6654 (25.4)4190 (31.5)19 174 (32.1)
      • ≥ 41660 (5.3)1433 (5.5)1819 (13.7)6767 (11.3)
    Sex
      • Female16 045 (51.1)13 857 (52.8)6845 (51.8)30 705 (51.4)
      • Male15 343 (48.9)12 369 (47.2)6370 (48.2)28 994 (48.6)
    Primary care provider
      • Yes11 501 (36.6)9727 (37.1)11 901 (89.4)27 692 (46.5)
      • No19 894 (63.4)16 503 (62.9)1411 (10.6)31 841 (53.5)
    Age, y
      • < 207138 (22.7)7308 (27.9)3968 (29.8)15 440 (25.8)
      • 20–4912 738 (40.6)12 017 (45.8)5086 (38.2)24 785 (41.4)
      • 50–748052 (25.6)5711 (21.8)3297 (24.8)14 682 (24.6)
      • ≥ 753466 (11.0)1192 (4.5)961 (7.2)4894 (8.2)
    • ED—emergency department, RCH—rural community hospital, UCC—urgent care centre, URH—urban regional hospital.

    • ↵* The totals from the 3 EDs do not add up to the overall total because 18.6% of the participants attended more than 1 of the EDs.

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    Table 2.

    Logistic regression model predicting frequent attenders

    VARIABLEODDS RATIO (95% CI)P VALUE
    Family physician1.56 (1.47–1.66)< .001
    Urban vs rural0.92 (0.86–0.98).014
    Male vs female0.76 (0.72–0.80)< .001
    Age, y
      • < 20 vs 20–490.95 (1.02–1.18).119
      • 50–74 vs 20–490.86 (0.80–0.94)< .001
      • ≥ 75 vs 20–491.10 (1.01–1.02).035
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Canadian Family Physician: 60 (4)
Canadian Family Physician
Vol. 60, Issue 4
1 Apr 2014
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Emergency department use
Erin Palmer, Denise Leblanc-Duchin, Joshua Murray, Paul Atkinson
Canadian Family Physician Apr 2014, 60 (4) e223-e229;

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Erin Palmer, Denise Leblanc-Duchin, Joshua Murray, Paul Atkinson
Canadian Family Physician Apr 2014, 60 (4) e223-e229;
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