USE OF EMERGENCY DEPARTMENTS FOR PREVENTATIVE CARE AMONG ADULTS IN THE UNITED STATES: ESTIMATES FROM THE 2017 NATIONAL HEALTH INTERVIEW SURVEY

Background: Use of the emergency department (ED) for routine or preventative care has been an abiding concern for policy makers and public health practitioners. Objectives: We utilized recent data to examine health-related, socioeconomic, and demographic factors associated with use of the ED for routine or preventative care using a national sample of adults. Methods: Data from the 2017 National Health Interview Survey, a nationally representative sample of 26,742 adults >= 18 years of age was used for this investigation. Bivariate and multivariate analyses were used to assess the association between reported use of EDs as a usual source of preventative care and health-related, socioeconomic, and demographic factors. Results: In 2017, approximately 2 million adults nationwide reported the ED as their usual source of preventative health care. Individuals experiencing >= 2 health care-related barriers were more likely to use the ED as a source of usual preventative care (odds ratio = 2.78 [95% confidence interval 1.64-4.72]). Individuals without insurance had higher odds (odds ratio = 9.52 [95% confidence interval 5.60-16.19]) of using the ED for care compared with those who were privately insured. In addition, those using the ED for preventative care were more likely to be younger, poorer, less educated, to identify as Asian or African American, and to reside in the Northeast United States. Conclusion: This study provides a current perspective into characteristics and factors contributing to use of the ED for preventative care. Overall, our findings suggest that the ED continues to provide crucial safety net services to a small subset of the population experiencing significant barriers to timely medical care. (C) 2019 Elsevier Inc. All rights reserved.