Sociodemographic Variables Associated with Self-Reported Emergency Department Utilization: A Cross-Sectional, Population-Based Analysis

BACKGROUND: Current evidence has established disparities in ED utilization across various demographic and socioeconomic groups. However, there is a paucity of recent evidence exploring the interaction of multiple sociodemographic variables and their influence on emergency department (ED) utilization. OBJECTIVES: To evaluate the influence and interaction of multiple sociodemographic variables on ED utilization. METHODS: Cross-sectional, population-based logistic regression analyses were conducted using the 2023 National Health Interview Survey (NHIS) data. RESULTS: Adjusted odds of ED utilization were significantly higher among female (OR 1.31, 95% CI 1.21-1.41, p < 0.001), Black (OR 1.16, 95% CI 1.03-1.31, p = 0.014) and American Indian/Alaskan (OR 1.37, 95% CI 1.04-1.81, p = 0.026) individuals. Compared to ages 18-25, individuals aged 50-74 (p < 0.05) had lower odds. Compared to participants >5x poverty threshold, those with income 2-5x poverty threshold, 1-2x poverty threshold, and <1x poverty threshold had 19% (p < 0.001), 40% (p < 0.001) and 52% (p < 0.001) increased odds of ED utilization, respectively. Individuals with Medicaid/public insurance (OR 1.43, 95% CI 1.29-1.59, p < 0.001) and high school education (OR 1.12, 95% CI 1.01-1.23, p = 0.025) had higher odds of ED utilization compared to those with private insurance and college education. Those without access to a usual place of care (OR 0.71, 95% CI 0.60-0.82, p < 0.001) had lower odds. Compared to participants in good health, those in fair (OR 2.03, 95% CI 1.84-2.25, p < 0.001) or poor (OR 4.4, 95% CI 3.77-5.24, p < 0.001) health had higher odds of ED visits. CONCLUSIONS: Sex, age, race, income, insurance coverage, education, self-reported health status and access to care are significant predictors of ED visits.