Factors related to emergency department use: Results from the Ontario health survey 1990**
Section snippets
INTRODUCTION
The annual rate of emergency department visits is higher in Canada than in the United States and continues to rise in both countries.1, 2 Although some of the increased use of EDs may be accounted for by rising health needs and trauma, it is still unclear why this growth in use continues. In Canada, where all residents have universal (single-payer) health insurance, this heavy use of emergency services occurs despite the availability of fully insured alternative health care providers.
We used
MATERIALS AND METHODS
The study data were derived from the 1990 OHS.7, 8 This survey was designed and implemented by Statistics Canada and the Ontario Ministry of Health. It was a comprehensive survey of 35,479 households in Ontario and included 61,239 individuals. In 1991, there were 3.7 million households and 10.1 million individuals in Ontario.9
The first part of the survey involved an interviewer-administered questionnaire that was completed by one member of the household, who answered the questions on behalf of
RESULTS
There were 60,972 individuals included in this analysis. The observations were weighted to represent the noninstitutionalized population of Ontario in 1990, approximately 9.7 million people. Overall, 21.1% of the population had one or more self-reported visits to the ED in the previous 12-month period. The survey yielded an estimate of approximately 3.4 million visits to EDs in the province over the 12-month period, for an average of 350 visits per 1,000 residents.
Age was significantly related
DISCUSSION
From the survey data, we estimated that more than one of every five people in Ontario had used the ED at least once in the previous 12 months. Of these users, nearly one third visited the ED more than once. Although the usage rates found in this study are high, these findings are best interpreted when they are examined in the context of other survey data. Statistics Canada data show that the rate of ED use continues to grow rapidly, with an 8.3% increase in the rate of use between 1985 and
CONCLUSION
Our study estimated that more than one out of every five people in Ontario visited an ED at least once in the previous 12 months. Of these, one third reported having two or more visits.
Other significant findings included the differences in ED use among groups, even after adjusting for other factors. Health needs (accidents, health problems, and health status) were found to be the largest underlying contributors to ED use. However, even after adjusting for factors that represented health need,
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