The analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies?
Abstract Background The individual factors associated to Frequent Users (FUs) in Emergency Departments are well known. However, the characteristics of their geographical distribution and how territorial specificities are associated and intertwined with ED use are limited. Investigating healthcare us...
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-021-11682-z |
| _version_ | 1819135563014340608 |
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| author | Romain Hellmann Anne-Laure Feral-Pierssens Alain Michault Enrique Casalino Agnès Ricard-Hibon Frederic Adnet Dominique Brun-Ney Donia Bouzid Axelle Menu Mathias Wargon |
| author_facet | Romain Hellmann Anne-Laure Feral-Pierssens Alain Michault Enrique Casalino Agnès Ricard-Hibon Frederic Adnet Dominique Brun-Ney Donia Bouzid Axelle Menu Mathias Wargon |
| author_sort | Romain Hellmann |
| collection | DOAJ |
| description | Abstract Background The individual factors associated to Frequent Users (FUs) in Emergency Departments are well known. However, the characteristics of their geographical distribution and how territorial specificities are associated and intertwined with ED use are limited. Investigating healthcare use and territorial factors would help targeting local health policies. We aim at describing the geographical distribution of ED’s FUs within the Paris region. Methods We performed a retrospective analysis of all ED visits in the Paris region in 2015. Data were collected from the universal health insurance’s claims database. Frequent Users (FUs) were defined as having visited ≥3 times any ED of the region over the period. We assessed the FUs rate in each geographical unit (GU) and assessed correlations between FUs rate and socio-demographics and economic characteristics of GUs. We also performed a multidimensional analysis and a principal component analysis to identify a typology of territories to describe and target the FUs phenomenon. Results FUs accounted for 278,687 (11.7%) of the 2,382,802 patients who visited the ED, living in 232 GUs. In the region, median FUs rate in each GU was 11.0% [interquartile range: 9.5–12.5]. High FUs rate was correlated to the territorial markers of social deprivation. Three different categories of GU were identified with different profiles of healthcare providers densities. Conclusion FUs rate varies between territories and is correlated to territorial markers of social deprivation. Targeted public policies should focus on disadvantaged territories. |
| first_indexed | 2024-12-22T10:21:04Z |
| format | Article |
| id | doaj.art-dd06e0f9b3b34e76b4dedae751f95564 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-22T10:21:04Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-dd06e0f9b3b34e76b4dedae751f955642022-12-21T18:29:38ZengBMCBMC Public Health1471-24582021-09-0121111210.1186/s12889-021-11682-zThe analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies?Romain Hellmann0Anne-Laure Feral-Pierssens1Alain Michault2Enrique Casalino3Agnès Ricard-Hibon4Frederic Adnet5Dominique Brun-Ney6Donia Bouzid7Axelle Menu8Mathias Wargon9Health Regional Agency of Ile de FranceSAMU 93 - Emergency Department, Avicenne hospital, Assistance Publique-Hôpitaux de ParisHealth Regional Agency of Ile de FranceEmergency Department, Bichat hospital, Assistance Publique-Hôpitaux de ParisEmergency Department, Centre hospitalier René DubosSAMU 93 - Emergency Department, Avicenne hospital, Assistance Publique-Hôpitaux de ParisDirection de l’organisation médicale et des relations avec l’université, Assistance Publique-Hôpitaux de ParisEmergency Department, Bichat hospital, Assistance Publique-Hôpitaux de ParisHealth Regional Agency of Ile de FranceEmergency Department, Centre Hospitalier de Saint-DenisAbstract Background The individual factors associated to Frequent Users (FUs) in Emergency Departments are well known. However, the characteristics of their geographical distribution and how territorial specificities are associated and intertwined with ED use are limited. Investigating healthcare use and territorial factors would help targeting local health policies. We aim at describing the geographical distribution of ED’s FUs within the Paris region. Methods We performed a retrospective analysis of all ED visits in the Paris region in 2015. Data were collected from the universal health insurance’s claims database. Frequent Users (FUs) were defined as having visited ≥3 times any ED of the region over the period. We assessed the FUs rate in each geographical unit (GU) and assessed correlations between FUs rate and socio-demographics and economic characteristics of GUs. We also performed a multidimensional analysis and a principal component analysis to identify a typology of territories to describe and target the FUs phenomenon. Results FUs accounted for 278,687 (11.7%) of the 2,382,802 patients who visited the ED, living in 232 GUs. In the region, median FUs rate in each GU was 11.0% [interquartile range: 9.5–12.5]. High FUs rate was correlated to the territorial markers of social deprivation. Three different categories of GU were identified with different profiles of healthcare providers densities. Conclusion FUs rate varies between territories and is correlated to territorial markers of social deprivation. Targeted public policies should focus on disadvantaged territories.https://doi.org/10.1186/s12889-021-11682-zHealthcare useFrequent usersAccess to careHealth geographyEmergency department |
| spellingShingle | Romain Hellmann Anne-Laure Feral-Pierssens Alain Michault Enrique Casalino Agnès Ricard-Hibon Frederic Adnet Dominique Brun-Ney Donia Bouzid Axelle Menu Mathias Wargon The analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies? BMC Public Health Healthcare use Frequent users Access to care Health geography Emergency department |
| title | The analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies? |
| title_full | The analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies? |
| title_fullStr | The analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies? |
| title_full_unstemmed | The analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies? |
| title_short | The analysis of the geographical distribution of emergency departments’ frequent users: a tool to prioritize public health policies? |
| title_sort | analysis of the geographical distribution of emergency departments frequent users a tool to prioritize public health policies |
| topic | Healthcare use Frequent users Access to care Health geography Emergency department |
| url | https://doi.org/10.1186/s12889-021-11682-z |
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