• Jacques Baillargeon, Chris R Thomas, Brie Williams, Charles E Begley, Sarghi Sharma, Brad H Pollock, Owen J Murray, John S Pulvino, and Ben Raimer.
• Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555, USA. jbaillar@utmb.edu
• Psychiatr Serv. 2008 Jul 1;59(7):808-11.

ObjectiveThis study examined medical emergency department utilization for patterns among uninsured patients with psychiatric disorders.MethodsBilling records of 15,672 uninsured adult patients treated in the emergency department of an academic medical center in southeast Texas over a 12-month period were analyzed for information on demographic characteristics, diagnosis, number of emergency department visits, and hospitalization.ResultsOverall, 11.8% of the population was diagnosed as having at least one psychiatric disorder during an emergency department visit. Patients with psychiatric disorders had an increased risk of having multiple emergency department visits and hospitalization compared with patients without psychiatric disorders. The risk of multiple emergency department visits was particularly high for patients with either bipolar disorder or psychotic disorders.ConclusionsUninsured patients with psychiatric disorders appear to be heavy users of medical emergency department services. These findings may be helpful in developing more efficient strategies to serve the mental health needs of the uninsured.

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