Recorded presentation

Jurek George Grabowski, MPH¹, Yandong Qiang, MD, MPH, MHS², and Guohua Li, MD DrPH². (1) School of Medicine, Department of Emergency Medicine, Johns Hopkins University, 1830 E. Monument St., Baltimore, MD 21287-2080, 410-502-7165, ggrabows@jhmi.edu, (2) Department of Emergency Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Baltimore, MD 21205

The objective of this study was to delineate the association between census block traits and the all-cause and the injury-specific emergency department (ED) utilization rates in a suburban hospital.

Discharge data for all patients attending an ED in 2001, were geocoded and merged to Census Bureau demographic and housing tenure data. The proportion of males, African Americans, owner-occupied housing units, population aged 18-49 years, and the distance to the ED were categorized into quartiles. All-cause and injury-specific ED visit rates were computed per block. Chi-Square and linear regression evaluated the relationships between neighborhood traits and ED utilization.

The overall all-cause and injury-specific rates of the 34,621 addresses, geocoded into 1,252 census blocks, were 14.0 and 5.2 per 100 population respectively. All-cause visit rates per 100 population increased from 10.2 where 0% of the population were African American to 18.4 for neighborhoods where >19% of residents were African American(p<0.01). All-cause visit rates per 100 population decreased from 16.8 where 0-79% of the housing units were owner occupied to 11.1 where 100% of housing units were owner occupied(p<0.01). Significant decreasing trends were noted for both all-cause and injury-specific rates as proportions of males and distance to the ED increased. Multivariate analysis revealed that the proportion of African American residents and the proportion of owner-occupied housing units were significantly associated with ED utilization, independent of the distance from residence to the study ED and other variables(p<0.0001).

Suburban ED utilization was significantly associated with neighborhood traits of race, age, and housing tenure composition.

Learning Objectives:

• To list and describe the importance of five neighborhood level characteristics that are associated with emergency department utilization.
• To discuss the importance of ecological studies in injury research.
• To articulate a procedure for delineating emergency department utilization using Geographic Information Systems (GIS) and census data.

Keywords: Emergency Department/Room, Methodology

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation