Non-compliance in the Emergency Department: Is there a Difference Between Medical and Psychiatric Patient's Reasons and use of the Emergency Department

Abstract

Background

It is estimated that on average up to 50% of patients are non-compliant with their medication, resulting in 28% emergency room visits costing about $8.5 billion annually.

Objectives

The purpose of this study was to examine, what, if any, differences there are between medical versus psychiatric non-compliant patients with regard to use of the emergency department (ED).

Methods

a random sample of patients who present to the ED for medical or psychiatric illnesses and who state that they were non-compliant with their medicine were given the National Healthaccess Survey. They were asked about sources of medical care, drug compliance and reason for non-compliance.

Results

There were a total of 300 participants in the study. There was no significant difference in the reason both medical and psychiatric patients gave for being non-compliant with their medications that resulted in their ED visit. Each group cited cost as the number one reason for not taking their medication as prescribed. The psychiatric participants who were more likely to get admitted disposition (P = .00), not afford mental health care (P = .01), were not able to get care from other places and used the ED for their psychiatric care (P = .02).

Conclusion

There was no difference between the two populations with regards to their reasons for non-compliance that brought them to the ED. Non-compliance of the psychiatric patients compared to the medical patients lead to a higher admission rate.

Disclosure of interest

The author has not supplied his declaration of competing interest.