Sociodemographic Influences of Emergency Department Care for Anxiety Disorders

J Behav Health Serv Res. 2018 Oct;45(4):593-604. doi: 10.1007/s11414-018-9598-7.

Abstract

This study examines variations in content of care for anxiety-related emergency department (ED) visits in the USA across various sociodemographic strata. The 2009-2012 National Hospital Ambulatory Medical Care Survey was used to identify all visits to general hospital EDs in which an anxiety diagnosis was recorded (n = 1930). Content and equitability of care was assessed utilizing logistic regression models. There were an estimated 1,856,000 ED visits with anxiety-related discharge diagnoses in the USA annually. Content of care and disposition varied by age, race/ethnicity, and insurance status. Visits by Medicaid patients were more likely than visits by privately insured patients to include a toxicology screen (OR = 1.67, p < .05) and visits by patients with either Medicaid or Medicare were less likely to include an EKG (OR = 0.53, p < .05 and OR = 0.52, p < .05, respectively). Understanding variations in ED care for anxiety can identify opportunities for intervention, both in the ED and upstream in appropriate healthcare settings.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Anxiety Disorders* / therapy
  • Delivery of Health Care / methods*
  • Demography
  • Electrocardiography / statistics & numerical data
  • Emergency Medicine / methods*
  • Emergency Service, Hospital / statistics & numerical data*
  • Ethnicity
  • Female
  • Health Care Surveys
  • Humans
  • Insurance Coverage
  • Logistic Models
  • Male
  • Medicaid
  • Medicare
  • Middle Aged
  • Quality of Health Care*
  • Socioeconomic Factors
  • United States
  • Young Adult