Use of emergency departments among working age adults with disabilities: a problem of access and service needs.

Objective: To examine the relationship between emergency department (ED) use and access to medical care and prescription medications among working age Americans with disabilities.

Data Source: Pooled data from the 2006-2008 Medical Expenditure Panel Survey (MEPS), a U.S. health survey representative of community-dwelling civilians.

Study Design: We compared the health and service utilization of two groups of people with disabilities to a contrast group without disability. We modeled ED visits on the basis of disability status, measures of health and health conditions, access to care, and sociodemographics.

Data Extraction: These variables were aggregated from the household component, the medical condition, and event files to provide average annual estimates for the period spanning 2006-2008.

Principal Findings: People with disabilities accounted for almost 40 percent of the annual visits made to U.S. EDs each year. Three key factors affect their ED use: access to regular medical care (including prescription medications), disability status, and the complexity of individuals' health profiles.

Conclusions: Given the volume of health conditions among people with disabilities, the ED will always play a role in their care. However, some ED visits could potentially be avoided if ongoing care were optimized.