B Michael Ray, Kyle J Kelleran, Maria C Kaisler, Andrew C Meltzer
{"title":"成人慢性腹痛急诊科就诊频率：来自2023年美国国家健康访谈调查的结果","authors":"B Michael Ray, Kyle J Kelleran, Maria C Kaisler, Andrew C Meltzer","doi":"10.1111/acem.70085","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Abdominal pain is a leading symptom prompting emergency department (ED) visits, but the specific contribution of chronic abdominal pain (CAP) to ED utilization is not well established. This study assessed whether CAP is associated with increased ED visits and identified predictors of ED utilization among individuals with CAP.</p><p><strong>Methods: </strong>Using the 2023 U.S. National Health Interview Survey (NHIS), CAP was defined as \"bothersome\" abdominal pain occurring \"most\" or \"every day\" over the prior 3 months. Comparisons were made by demographics, disability, mental health conditions, past medical history (PMH), and social determinants of health (SDOH). Multinomial regression models identified predictors of single and multiple ED visits, and an aggregate model assessed the impact of BioPsychoSocial variables.</p><p><strong>Results: </strong>CAP was reported by 2.8% (n = 4,585,878) of respondents and was associated with higher percentages of disability (31.7% vs. 7.2%), anxiety (51.9% vs. 17.6%), depression (49.4% vs. 17.8%), comorbidities such as hypertension (46.5% vs. 30.6%), and SDOH-related challenges like difficulty refilling prescriptions (23.8% vs. 5.2%) and cost-related care access (22.6% vs. 5.9%). CAP increased the odds of a single ED visit (OR: 2.2, 95% CI: 1.7-2.9) and multiple visits (OR: 4.2, 95% CI: 3.2-5.6). Adjusting for PMH reduced the odds of single ED visits by 33% (OR: 1.7, 95% CI: 1.2-2.3), while adjusting for SDOH reduced multiple visits by 100.1% (OR: 2.1, 95% CI: 1.5-2.9). The aggregate model reduced the odds of single and multiple visits by 49.4% and 120%, respectively (Single OR: 1.5, 95% CI: 1.1-2.0; Multiple OR 1.9, 95% CI: 1.4-2.7).</p><p><strong>Conclusion: </strong>This nationally representative analysis suggests that individuals with CAP have significantly higher ED utilization and face greater burdens of disability, mental health conditions, comorbidities, and SDOH-related barriers. These findings highlight the potential value of addressing BioPsychoSocial factors to reduce ED reliance and support comprehensive care for CAP patients.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Emergency Department Visit Frequency Among Adults With Chronic Abdominal Pain: Findings From the 2023 US National Health Interview Survey.\",\"authors\":\"B Michael Ray, Kyle J Kelleran, Maria C Kaisler, Andrew C Meltzer\",\"doi\":\"10.1111/acem.70085\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Abdominal pain is a leading symptom prompting emergency department (ED) visits, but the specific contribution of chronic abdominal pain (CAP) to ED utilization is not well established. This study assessed whether CAP is associated with increased ED visits and identified predictors of ED utilization among individuals with CAP.</p><p><strong>Methods: </strong>Using the 2023 U.S. National Health Interview Survey (NHIS), CAP was defined as \\\"bothersome\\\" abdominal pain occurring \\\"most\\\" or \\\"every day\\\" over the prior 3 months. Comparisons were made by demographics, disability, mental health conditions, past medical history (PMH), and social determinants of health (SDOH). Multinomial regression models identified predictors of single and multiple ED visits, and an aggregate model assessed the impact of BioPsychoSocial variables.</p><p><strong>Results: </strong>CAP was reported by 2.8% (n = 4,585,878) of respondents and was associated with higher percentages of disability (31.7% vs. 7.2%), anxiety (51.9% vs. 17.6%), depression (49.4% vs. 17.8%), comorbidities such as hypertension (46.5% vs. 30.6%), and SDOH-related challenges like difficulty refilling prescriptions (23.8% vs. 5.2%) and cost-related care access (22.6% vs. 5.9%). CAP increased the odds of a single ED visit (OR: 2.2, 95% CI: 1.7-2.9) and multiple visits (OR: 4.2, 95% CI: 3.2-5.6). Adjusting for PMH reduced the odds of single ED visits by 33% (OR: 1.7, 95% CI: 1.2-2.3), while adjusting for SDOH reduced multiple visits by 100.1% (OR: 2.1, 95% CI: 1.5-2.9). The aggregate model reduced the odds of single and multiple visits by 49.4% and 120%, respectively (Single OR: 1.5, 95% CI: 1.1-2.0; Multiple OR 1.9, 95% CI: 1.4-2.7).</p><p><strong>Conclusion: </strong>This nationally representative analysis suggests that individuals with CAP have significantly higher ED utilization and face greater burdens of disability, mental health conditions, comorbidities, and SDOH-related barriers. These findings highlight the potential value of addressing BioPsychoSocial factors to reduce ED reliance and support comprehensive care for CAP patients.</p>\",\"PeriodicalId\":7105,\"journal\":{\"name\":\"Academic Emergency Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-06-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Academic Emergency Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/acem.70085\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/acem.70085","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
Emergency Department Visit Frequency Among Adults With Chronic Abdominal Pain: Findings From the 2023 US National Health Interview Survey.
Objective: Abdominal pain is a leading symptom prompting emergency department (ED) visits, but the specific contribution of chronic abdominal pain (CAP) to ED utilization is not well established. This study assessed whether CAP is associated with increased ED visits and identified predictors of ED utilization among individuals with CAP.
Methods: Using the 2023 U.S. National Health Interview Survey (NHIS), CAP was defined as "bothersome" abdominal pain occurring "most" or "every day" over the prior 3 months. Comparisons were made by demographics, disability, mental health conditions, past medical history (PMH), and social determinants of health (SDOH). Multinomial regression models identified predictors of single and multiple ED visits, and an aggregate model assessed the impact of BioPsychoSocial variables.
Results: CAP was reported by 2.8% (n = 4,585,878) of respondents and was associated with higher percentages of disability (31.7% vs. 7.2%), anxiety (51.9% vs. 17.6%), depression (49.4% vs. 17.8%), comorbidities such as hypertension (46.5% vs. 30.6%), and SDOH-related challenges like difficulty refilling prescriptions (23.8% vs. 5.2%) and cost-related care access (22.6% vs. 5.9%). CAP increased the odds of a single ED visit (OR: 2.2, 95% CI: 1.7-2.9) and multiple visits (OR: 4.2, 95% CI: 3.2-5.6). Adjusting for PMH reduced the odds of single ED visits by 33% (OR: 1.7, 95% CI: 1.2-2.3), while adjusting for SDOH reduced multiple visits by 100.1% (OR: 2.1, 95% CI: 1.5-2.9). The aggregate model reduced the odds of single and multiple visits by 49.4% and 120%, respectively (Single OR: 1.5, 95% CI: 1.1-2.0; Multiple OR 1.9, 95% CI: 1.4-2.7).
Conclusion: This nationally representative analysis suggests that individuals with CAP have significantly higher ED utilization and face greater burdens of disability, mental health conditions, comorbidities, and SDOH-related barriers. These findings highlight the potential value of addressing BioPsychoSocial factors to reduce ED reliance and support comprehensive care for CAP patients.
期刊介绍：
Academic Emergency Medicine (AEM) is the official monthly publication of the Society for Academic Emergency Medicine (SAEM) and publishes information relevant to the practice, educational advancements, and investigation of emergency medicine. It is the second-largest peer-reviewed scientific journal in the specialty of emergency medicine.
The goal of AEM is to advance the science, education, and clinical practice of emergency medicine, to serve as a voice for the academic emergency medicine community, and to promote SAEM''s goals and objectives. Members and non-members worldwide depend on this journal for translational medicine relevant to emergency medicine, as well as for clinical news, case studies and more.
Each issue contains information relevant to the research, educational advancements, and practice in emergency medicine. Subject matter is diverse, including preclinical studies, clinical topics, health policy, and educational methods. The research of SAEM members contributes significantly to the scientific content and development of the journal.
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