Depression Linked to Frequent Emergency Department Use in Large 10-year Retrospective Analysis of an Integrated Health Care System

We evaluated general patient features related to depression and frequency of Emergency Department (ED) use in a large integrated health care system. Electronic Health Records of 287,281 adults from a general patient population were studied retrospectively over a 10-year period. Patients with a history of depression were more likely to be seen in the ED and at higher frequency than those without. Frequent ED users were more likely to have a history of depression or psychiatric medication orders than infrequent users. ED visits by depression patients and frequent users have highly correlated complaints and discharge diagnoses with other ED users, often related to pain. Poorly managed depression may be playing a role in frequent ED utilization which may be addressed by universal screening for depression, evaluation of barriers to treatment, and other novel interventions to improve care coordination.