Evidence map›Paper›PMID 30782688›Full record

ArticleBMJ open2019

How much emergency department use by vulnerable populations is potentially preventable?: A period prevalence study of linked public hospital data in South Australia.

David Banham, Jonathan Karnon, Kirsten Densley, John W Lynch

Abstract read
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Acute care utilization for ambulatory care-sensitive conditions among publicly insured children.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024
    Article
  4. Article
  5. Article
  6. Article
  7. Overuse of Health Care in the Emergency Services in Chile.International journal of environmental research and public health · 2021
    Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

David BanhamSchool of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
Jonathan KarnonSchool of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
Kirsten DensleyFlinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, South Australia, Australia.
John W LynchSchool of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.

Funding

HSRD VA RRP 11-406
6 · The paper itself

Abstract

objectivesTo quantify emergency department (ED) presentations by individuals within vulnerable populations compared with other adults and the extent to which these are potentially preventable.

designPeriod prevalence study from 2005-2006 to 2010-2011.

settingPerson-linked, ED administrative records for public hospitals in South Australia.

participantsAdults aged 20 or more in South Australia's metropolitan area presenting to ED and categorised as Refugee and Asylum Seeker Countries of birth (RASC); Aboriginal; those aged 75 years or more; or All others.

main outcome measuresUnadjusted rates of ambulatory care sensitive condition (ACSC), general practitioner (GP)-type presentations and associated direct ED costs among mutually exclusive groups of individuals.

resultsDisparity between RASC and All others was greatest for GP-type presentations (423.7 and 240.1 persons per 1000 population, respectively) with excess costs of $A106 573 (95% CI $A98 775 to $A114 371) per 1000 population. Aboriginal had highest acute ACSC presenter rates (125.8 against 51.6 per 1000 population) with twice the risk of multiple presentations and $A108 701 (95% CI $A374 to $A123 029) per 1000 excess costs. Those aged 75 or more had highest chronic ACSC presenter rates (119.7vs21.1 per 1000), threefold risk of further presentations (incidence rate ratio 3.20, 95% CI 3.14 to 3.26) and excess cost of $A385 (95% CI $A178 160 to $A184 609) per 1000 population.

conclusionsVulnerable groups had excess ED presentations for a range of issues potentially better addressed through primary and community healthcare. The observed differences suggest inequities in the uptake of effective primary and community care and represent a source of excess cost to the public hospital system.

Indexed as

AdultAgedCross-Sectional StudiesEmergency Service, HospitalFemaleHealthcare DisparitiesHospital CostsHospitalizationHospitals, PublicHumansMaleMiddle AgedPatient Acceptance of Health CarePrimary PreventionRisk FactorsSecondary Preventiondelivery of health careelderlyemergency departmentshospital costsindigenous populationrefugees

Identifiers

PMID30782688
PMCPMC6340627

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Registered trials

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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.