ArticleBMC health services research2025
Emergency department visits among rural and urban older adults: disparities in ambulatory and emergency care sensitive conditions.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
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Who cites it
7 citing papers in PubMed.
- Hospital admissions for ambulatory care-sensitive conditions among people with gout and other crystal arthropathies in Alberta, Canada: a population-based matched cohort study.Lancet regional health. Americas · 2026Article
- Health Care Contact Days Among Older Adults After Emergency Department Visits: A Cross-Sectional Analysis.Journal of the American Geriatrics Society · 2026Article
- The Leaky Pipeline of Injury: Disparities at Multiple Junctures for Children with Head Trauma.The Journal of pediatrics · 2026Article
- Perspectives on Attrition Among Emergency Physicians.JAMA network open · 2026Article
- Socioeconomic Disparities in Concussion Presentation.JAMA network open · 2026Article
- Marginal Dispositions and Shared Decision-Making Among Older Adults in the ED: A Prospective Cohort Study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Stranded in the emergency department: an analysis of boarding trends in older adults in the United States.Health affairs scholar · 2025Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundOlder adults in rural geographies may be uniquely vulnerable to difficulty accessing outpatient care, and therefore more reliant on emergency department (ED) care. We compared ED utilization for ambulatory care sensitive conditions (ACSCs) and emergency care sensitive conditions (ECSCs) among rural and urban Medicare beneficiaries.
methodsWe conducted a pooled cross-sectional analysis of 2016-2020 Medicare Current Beneficiary Survey data, assessing ED visitation rates for ACSCs and ECSCs. We present ED visit rates per 100 beneficiary-years and estimated logistic regression models to quantify the odds of having any ED visit, any ACSC-related ED visit, or any ECSC-related ED visit in a given year among older adults in rural and urban areas, adjusting for sociodemographic and health characteristics.
resultsOur sample included 70,830 beneficiary-years, with 17,052 (24.1%) being from beneficiaries residing in rural areas. Rural beneficiaries had higher ED visit rates, with a weighted mean (SD) of 59.2 ED visits (14.1) per 100 beneficiary-years across study years, 11.5 (1.3) for ACSC-related, and 20.6 (3.5) for ECSC-related visits, compared to 43.2 (9.2), 7.2 (0.9), and 15.2 (1.9) ED visits, respectively, for urban beneficiary-years. In adjusted models, rural beneficiaries had a 49% higher odds of having an ED visit (OR: 1.49, 95% CI: 1.40-1.59), a 30% higher odds of an ACSC-related ED visit (OR: 1.30, 95% CI: 1.04-1.64), and a 26% higher odds of an ECSC-related ED visit (OR: 1.26, 95% CI: 1.05-1.50) within a given year when compared to urban counterparts.
conclusionsRural Medicare beneficiaries consistently showed higher ED utilization for ACSCs and ECSCs compared to urban beneficiaries, highlighting potential disparities in healthcare access and a need for targeted or policy-based interventions.
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