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School of Pharmacy


Pharmaceutical Systems and Policy


Objective: The objective of this study was to examine the association of patient- and county-level factors with the emergency department (ED) visits among adult fee-for-service (FFS) Medicaid beneficiaries residing in Maryland, Ohio, and West Virginia. Methods: A cross-sectional design using retrospective observational data was implemented. Patient-level data were obtained from 2010 Medicaid Analytic eXtract files. Information on county-level health-care resources was obtained from the Area Health Resource file and County Health Rankings file. Results: In adjusted analyses, the following patient-level factors were associated with higher number of ED visits: African Americans (incidence rate ratios [IRR] ¼ 1.47), Hispanics (IRR ¼ 1.63), polypharmacy (IRR ¼ 1.89), and tobacco use (IRR ¼ 2.23). Patients with complex chronic illness had a higher number of ED visits (IRR ¼ 3.33). The county-level factors associated with ED visits were unemployment rate (IRR ¼ 0.94) and number of urgent care clinics (IRR ¼ 0.96). Conclusion: Patients with complex healthcare needs had a higher number of ED visits as compared to those without complex healthcare needs. The study results provide important baseline context for future policy analysis studies around Medicaid expansion options.

Source Citation

Agarwal, P., Bias, T. K., Madhavan, S., Sambamoorthi, N., Frisbee, S., & Sambamoorthi, U. (2016). Factors Associated With Emergency Department Visits. Health Services Research and Managerial Epidemiology, 3, 233339281664854.


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