Cited by 281Emergency and Acute Care StudiesAdolescent and Pediatric HealthcarePrimary Care and Health Outcomes

Adolescents Who Use the Emergency Department as Their Usual Source of Care

Wilson, Karen M., Klein, Jonathan D.·2000·Archives of Pediatrics & Adolescent Medicine

Abstract

OBJECTIVE: To examine the factors associated with use of the emergency department (ED) as the only source of health care among adolescents. DESIGN: Analyses of the 1997 Commonwealth Fund Survey of the Health of Adolescent Girls, a nationally representative sample of 6748 in-school male and female adolescents in 5th through 12th grade. The X2 statistics and logistic regression analyses were computed with the use of SUDAAN. RESULTS: Overall, 4.6% of the adolescents in the survey, or 1.5 million adolescents in the United States, reported that the ED was their usual source of health care. In multivariate models, factors associated with the use of the ED included male sex, African American ethnicity, fewer financial resources, and living in a rural area. Adolescents with higher levels of risky behaviors, a history of physical or sexual abuse, and higher depression scores were all more likely to use the ED as their usual source of care. Adolescents who reported using the ED as their usual care source were also less likely to have had regular well visits and were more likely to report having missed needed care than those with other sources of primary care. CONCLUSIONS: Adolescents who use the ED as their usual source of care are often from vulnerable populations. Many have special mental or physical needs that are unlikely to be met with ED visits only, and they are likely to have missed care they needed. Creating linkages between EDs and other services could help at-risk adolescents identify and use more appropriate sources of primary care.

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Crossref · 10.1001/archpedi.154.4.361

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Authors
Wilson, K. M., & Klein, J. D.
Affiliations
University of Rochester Medicine (US)
Venue
Archives of Pediatrics & Adolescent Medicine
Published
2000-04-01
Volume
154
Issue
4
Pages
361
ISSN
1072-4710 (ISSN-L)
OpenAlex
W2108469410
Cited by
281
References
22
Citations by year
2026: 5 · 2025: 16 · 2024: 18 · 2023: 12 · 2022: 19 · 2021: 20 · 2020: 14 · 2019: 21 · 2018: 16 · 2017: 14 · 2016: 20 · 2015: 7 · 2014: 11 · 2013: 17 · 2012: 8
FWCI
3.32
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
  • Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords
emergency department utilization, usual source of care, adolescents, primary care access, missed nursing care, health care utilization, risk-taking, physical abuse, sexual abuse, depression, financial resources, rural residence, African American adolescents, gender differences
MeSH terms
Adolescent, Black or African American, Emergency Service, Hospital, Female, Health Services Accessibility, Humans, Male, Rural Population, Socioeconomic Factors, United States, Adolescent Health Services

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