Factors related to emergency department use: results from the Ontario Health Survey 1990

Objectives — To assess factors related to emergency department use in the Ontario population.

Design — Population-based, cross-sectional study weighted to represent the entire noninstitutionalized population of the province.

Participants — The 1990 Ontario Health Survey population sample of 60,972 individuals.

Interventions — Responses were given to survey questions on whether the ED had been visited in the past 12 months and, if so, how many times.

Results — Overall, 21.1% of all Ontario residents had had at least one visit to the ED in the preceding 12 months. Of these residents, 30.1% reported having two or more visits. Factors associated with increased ED use were described and tested with univariate and multivariate analysis, comparing the usage rates of ED users with those of nonusers and those of repeat users with those of one-time users. In all of the analyses, health needs (significant accidents, number of health problems, and self-reported health status) were the strongest determinants of ED use. However, even after adjusting for these health needs in the multivariate models, there still were significant variations in ED utilization among groups.

Conclusion — Our study estimated that approximately one in five Ontario residents had reported one or more visits to the ED in the past 12 months. There were identifiable subgroups in the population with increased ED usage even after adjustment for health needs factors.