Date of Conferral

2017

Degree

Ph.D.

School

Public Health

Advisor

Jennifer Oliphant

Abstract

Emergency departments (ED) are an integral component of the United States' health care system. The underlying factors related to ED use among Arizona's mentally ill are not fully understood and the patterns necessary to classify patients as frequent users have not been examined. The purpose of this study was to increase the understanding of frequent users and further examine the conditions by which they present to the ED. The theoretical foundation for this study was the fourth version of Andersen's behavioral model (1995) and this model's use to frame this study allowed for an objective analysis of ED use among Arizonans. The sample consisted of Arizona Department of Health Services-Department of Behavioral Services [AZDHS-DBS], ED discharge data, FY2013. The study addressed the gap in the literature using exploratory techniques and was guided by quantitative factor analysis. These multivariate techniques allowed for an analysis of the loading factors for each variable. The major findings from this study revealed a lack of generalizability based on a smaller than anticipated sample size; thus, halting further exploration within the sample for mental disorder, a key component to Research Question 1 and the overall study. Findings from Research Question 2 revealed the factors of race and payer as the best predictors of an ED visit. Study findings revealed ED visitors were most likely White females, 50 years of age or younger, and recipients of Medicaid. These study findings can inform clinical professionals within emergency medicine (EM) in the state of Arizona. This research has provided evidence that can be used by these professionals to promote positive social change and prompt additional primary research study efforts in healthcare utilization among Arizonans.

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