The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.

-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

From Divorce Court to Emergency Room

Bryce J. Christensen and Robert W. Patterson

Public-health officials claim that one reason medical costs have spiraled out of control is that a growing number of men and women routinely rely on the emergency room, often in dealing with ailments that could be dealt with elsewhere at lower cost. An Australian study provides clear evidence that the Divorce Revolution has helped to create this costly problem.

Conducted by researchers at a number of clinical programs in Victoria, Australia, this study focuses on a problem not only in Australia but also North America and the United Kingdom: namely, that of “the increasing demand placed on hospital Emergency Departments (EDs) by patients who frequently present [i.e., come to these departments seeking care].” To assess the scope and nature of this problem, the researchers analyze data drawn from admission records for regional emergency departments (what Americans call emergency rooms) from March 2009 to March 2010. These data suggest that marital status matters a good deal in determining who shows up frequently at the emergency room seeking medical care.

Defining “Frequent Presenters” (FPs) as individuals who came to an Emergency Room seeking care eight or more times during this one-year period, the researchers determined that individuals who were Frequent Presenters were more than twice as likely as Non-Frequent Presenters (NFPs) to be divorced or separated (Odds Ratio, 2.2; p < 0.0001). On the other hand, compared to the unmarried (single, divorced, and separated), married individuals were decidedly underrepresented among the Frequent Presenters (Odds Ratio, 0.61; p < 0.0001.)

Emphasizing the cost of the heavy reliance upon emergency-room care apparently fostered by marital breakdown, the researchers note that, compared to Non-Frequent Presenters, Frequent Presenters were “more likely to utilise the ambulance service to arrive at the hospital, or in the custody of police” and were also “more likely to be admitted to hospital, [and] more likely to have an admission to a mental health bed.”

The researchers see in their findings “major implications for the utilisation of limited ED [Emergency Department] resources by frequent presenters.” And they call for “further research analysing the effectiveness of targeted multidisciplinary interventions aiming to reduce the frequency of ED attendances.” That research might profitably begin with a search for ways to increase the number of couples heading to wedding chapels and decrease the number heading to divorce courts.

(Donna Markham and Andis Graudins, “Characteristics of Frequent Emergency Department Presenters to an Australian Emergency Medicine Network,” BMC Emergency Medicine 11 [December 16, 2011]: 21.)