Observational studyJournal of the American Geriatrics Society2014
Primary care availability and emergency department use by older adults: a population-based analysis.
Observational study in Journal of the American Geriatrics Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Factors associated with frequent use of emergency-department services in a geriatric population: a systematic review.BMC geriatrics · 2019Pooled it
- Impact of social care supply on healthcare utilisation by older adults: a systematic review and meta-analysis.Age and ageing · 2019Pooled it
- Association Between Usual Clinician Presence and Emergency Department Revisitation.Journal of the American Geriatrics Society · 2026Article
- Caregiver Burden and 30-Day Emergency Department Revisits.JAMA network open · 2025Article
- Availability of behavioral health crisis care and associated changes in emergency department utilization.Health services research · 2025Article
- Vaccination Motivators and Deterrents Among Undervaccinated Older Adults in North Dakota.Journal of community health · 2024Article
- The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use - results of a scoping review.International journal for equity in health · 2024Article
- Hospital Proximity and Emergency Department Use among Assisted Living Residents.Journal of the American Medical Directors Association · 2023Article
- Differences between recorded diagnoses of patients of an emergency department and office-hours primary care doctors: a register-based study in a Finnish town.International journal of circumpolar health · 2021Article
- Common step-wise interventions improved primary care clinic visits and reduced emergency department discharge failures: a large-scale retrospective observational study.BMC health services research · 2019Observational
- Review
- A National Study of U.S. Emergency Departments: Racial Disparities in Hospitalizations for Heart Failure.American journal of preventive medicine · 2018Article
- Geographical variation of diabetic emergencies attended by prehospital Emergency Medical Services is associated with measures of ethnicity and socioeconomic status.Scientific reports · 2018Observational
- Development and Validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department (ED) Visits: The ED Prevention Quality Indicators for General Health Conditions.Health services research · 2017Article
- ED Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults.Journal of emergency nursing · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectivesTo assess the relationship between the number of primary care providers (PCPs) in an area and emergency department (ED) visits by older adults.
designPopulation-based cross-sectional observational study.
settingNonfederal EDs in North Carolina in 2010.
participantsAll older adults (n = 640,086) presenting to a nonfederal ED in North Carolina in 2010. MEASUREMENTS: The primary outcome was the number of ED visits by older adults in each ZIP code per 100 adults aged 65 and older living in that ZIP code. A secondary outcome was the number of ED visits not resulting in hospital admission per 100 older adults. The primary predictor variable was the number of PCPs per 100 older residents for each ZIP code. Covariates included those representing healthcare need (Medicare hospitalizations, nursing home beds), predisposing factors for healthcare use (race, education, population density of older adults), and enabling factors (distance to the nearest ED).
resultsIn a multivariable regression model corrected for spatial clustering, ZIP code characteristics associated with ED visits included more hospitalizations by Medicare beneficiaries, more nursing home beds, and closer proximity to an ED. Number of PCPs per 100 older adult residents in each ZIP code was not associated with ED use, and the 95% confidence limit indicates at most a small effect of PCP availability on ED use.
conclusionThese findings suggest that primary care availability has at most a limited effect on ED use by older adults in North Carolina.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.