Emergency Room Treatment Twice as Likely Among Young Adults With Psychological Problems

Young adults with serious psychological problems are more than twice as likely as peers to use hospital emergency department services, according to a new study led by BU School of Public Health researchers.

The study, published online in the journal Social Psychiatry and Psychiatric Epidemiology, found that “serious psychological distress” was significantly associated with emergency department utilization among young adults. The authors noted that excess emergency room use is expensive and leads to overcrowding and long waits, and they suggested that efforts be made to increase community intervention and treatment options for young adults with mental health problems.

“Improvements in affordability of and accessibility to primary care could be a solution worth further research and examination,” they said.

James Burgess
James Burgess
Kathleen Carey
Kathleen Carey

The study was co-authored by Min-Ting Lin, formerly a BUSPH Master of Science in Health Services research student; James Burgess, professor of Health Policy & Management; and Kathleen Carey, associate professor of Health Policy & Management.

The researchers used data from the National Health Interview Survey (NHIS), which contains healthcare utilization and other information. They looked at emergency room visits and mental health diagnoses for more than 16,000 young adults, ages 18 to 29.

Young adults with serious psychological distress were 2.05 times more likely to go to an emergency room, while those who also smoked were 2.52 more likely. The researchers found that those with psychological problems who also were heavy drinkers did not have an elevated risk of emergency department, or ED, use.

“Attempts to decrease excess ED use and the development of strategies to improve mental health among young adults are needed to improve patient health and reduce the health-care burden of high costs and deteriorating ED care quality,” the authors said. They noted that mental illness is the second leading cause of disease burden in the U.S., and that psychological distress has been linked with an increased risk of mortality and with deaths from coronary heart disease in men.

Past research also has demonstrated an association between mental health problems and suicidal behavior and self-harm, which were common among ED presentations in this age group, the authors said.

In another of its findings, related to health insurance, the study indicated that the proportion of uninsured individuals increased in the group of young adults who had serious psychological distress [SPD].

“Since SPD could be seen as a chronic health condition which requires health care over an extended period, the elevated percentage of the uninsured in the SPD group indicated that health-care access concerns could be leading to unmet health-care needs in this population,” the authors said.

http://www.springerlink.com/content/el55718687184140/fulltext.html

Submitted by Lisa Chedekel

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