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Opiate prescriptions among drivers of veterans' ER use

April 11, 2013
by Gary A. Enos, Editor
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Use of prescription opiates makes the list of factors strongly associated with emergency department use among veterans, according to a new study suggesting that veterans’ access to care has not lessened demand for emergency services in some cases.

The study, published online this week in the Annals of Emergency Medicine, states that around 7% of patients in the Veterans Health Administration (VHA) system visit an emergency department at least twice a year, despite access to a variety of behavioral healthcare and preventive services.

Factors strongly associated with all levels of emergency department use, according to the study, are schizophrenia, homelessness, opiate prescriptions being filled, and heart failure. The study is titled “What Drives Frequent Emergency Department Use in an Integrated Health System: National Data from the Veterans Health Administration.”

“Just as we see in the civilian population, frequent users of the ER in the VHA generally have severely compromised life circumstances and high levels of psychosocial dysfunction in addition to medical needs,” said Kelly Doran, MD, of the Robert Wood Johnson Foundation Clinical Scholars Program at the Yale University School of Medicine and the U.S. Department of Veterans Affairs in New Haven, Conn.

An editorial accompanying the study states that the results regarding ER use by veterans suggest that emergency care should not be undermined to save money, but actually enhanced to ensure that high-need patients are served effectively.