Individual characteristics and the use of emergency room services among adolescents and young adults

Abstract

Predictors of emergency room (ER) service utilization and the visit rate among young people in 2005-2010 were investigated using a panel data model. Students (N=416) completed a questionnaire concerning their health and psychosocial characteristics at ages 13-18 and 19-24 years. Data regarding the utilization of ER services were gathered from the medical records of the local public primary healthcare services. Multivariable logistic regression models were used to compute incidence rate ratios, odds ratios and the unsystematic variance component Rho (ρ), for ER utilization. Male gender was associated with a lower ER visit rate (OR 0.5, 95% CI 0.3-0.7, p<0.001). Good school performance among males at baseline was associated with decreased ER use (native language OR 0.1, 95% CI 0.0-0.6, p=0.01; general subjects OR 0.2, 95% CI 0.0-0.6, p=0.009). Alcohol consumption among females at baseline (OR 2.1, 95% CI 1.0-4.4, p=0.047), and not studying or working among females on follow-up (OR 2.2, 95% CI 1.1-4.3, p=0.02) associated with ER service utilization. Abuse in childhood (OR 2.7, 95% CI 1.5-4.8, p=0.001) and mental health problems among males (OR 5.9, 95% CI 1.6-22.0, p=0.008) associated with an increased ER service visit rate. The contribution of unmeasured factors, or the individual style, was estimated as unobserved heterogeneity Rho (ρ), which was associated with ER service utilization (OR 0.46, 95% CI 0.3-0.6 for males and OR 0.60, 95% CI 0.5-0.7 for females, p<0.001). There is a higher tendency among young people with psychosocial problems to utilize ER services. The individual style of health behaviour predicts ER service utilization, especially among females. Healthcare providers should pay particular attention to the health behaviours and mental health of young people who recurrently use ER services.