The RHRPRC is studying the prevalence of emergency department utilization for behavioral health diagnoses between rural and urban communities. Between 1992 and 2001 "mental health-related visits constitute[d] a significant and increasing burden of care in U.S. emergency departments". In 2006, 4.7 million patients presented to American emergency departments with a primary psychiatric diagnosis, a rate of approximately 20 visits per 100 adults.

This previous study employed data from the National Hospital Ambulatory Medical Care Survey by using behavioral health-related ICD-9-CM, E, and V codes as well as behavioral health-related reasons for visit; however, the previous report did not address variability between levels of rural, but instead made a metro/non-metro comparison. The sample size for non-metro here was small. Similarly, many national surveys do not draw a representative sample of rural respondents.

This research will utilize the RUCA code and the State Emergency Department Databases (SEDD) under the Healthcare Cost and Utilization Project (HCUP) to explore:

• The prevalence in presentation to the emergency department with a primary or secondary diagnosis of a mental health disorder between rural/urban areas;
• Prevalence in presentation to the emergency department with a primary or secondary diagnosis of a mental disorder across payer types and geography;
• Mental health disorder diagnoses most prevalent by rural/urban area.

Publications

• Identifying Variability in Patient Characteristics and Prevalence of Emergency Department Utilization for Mental Health Diagnoses in Rural and Urban Communities
  Journal Article
  North Dakota and NORC Rural Health Reform Policy Research Center
  Date: 10/2017
  Patients needing behavioral healthcare can get more appropriate, cost-effective treatment if they are redirected from emergency departments (EDs). This study examined whether a larger proportion of rural versus urban patients went to went to EDs.
• Rural and Urban Utilization of the Emergency Department for Mental Health and Substance Abuse
  Policy Brief
  North Dakota and NORC Rural Health Reform Policy Research Center
  Date: 06/2017
  Utilizes data from the Healthcare Cost and Utilization Project's (HCUP's) State Emergency Department Databases (SEDD) for seven states. Researchers explore, and describe in this brief, the use of the Emergency Department for mental health and substance abuse among Urban, Large Rural, Small Rural, and Isolated Small Rural residents.
• Use of the Emergency Department for Mental Health and Substance Abuse Among Women
  Fact Sheet
  North Dakota and NORC Rural Health Reform Policy Research Center
  Date: 07/2017
  This study identifies trends among women in rural and urban communities who utilize the emergency department for mental health and substance abuse. The information can be used to help communities provide more relevant, appropriate, and less costly care.