Non-compliance in the Emergency Department: is There a Difference Between the Reasons Medical and Psychiatric Patients Use the Emergency Department?

Abstract

Purpose

The purpose of this study is to determine if there are any, differences between medical and psychiatric non-compliant patients with regard to their use of the Emergency Department (ED) and the reasons for their non- compliance.

Methods

A random sample of patients who presented to the ED for medical or psychiatric illnesses who stated that they were non-compliant with their medical protocols were given the National Health Access Survey. The survey asked about sources of medical care, drug compliance and reason for non-compliance, such as access and cost of health care and medication.

Results

There were a total of 303 participants in the study. There was no significant difference in the reasons the two groups 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 (50%), to get admitted, stated that they could not afford mental health care (40%), were not able to get care from other places, and used the ED for their psychiatric care (60%).

Conclusion

There was no difference between the two populations with regards to their reasons for non- compliance that brought them to the ED. But non-compliance of the psychiatric patients led to a higher admission rate than that seen in the non-compliant medical patient population.