Certain patients with one or more chronic diseases will come to the Emergency Department (ED) to get a drug refill. Certain risk factors can help identify these patients and may suggests ways to reduce this behavior. The authors are from the University of Texas Southwestern and Parkland Health and Hospital System in Dallas.

Patient selection: patient with chronic disease requiring refill of an essential medicine


Factors identifying a person who is likely to come to the ED for the drug refill:

(1) age < 50 years

(2) Afro-American

(3) low income (less than $5,000 per year)

(4) unfamiliar with what the numbers on the drug container mean (refill number, pharmacy phone number, etc.)

(5) told by the pharmacy to call the primary physician in order to get a refill order

(6) self-pay status (uninsured)

(7) admitted to the hospital in the previous 12 months

(8) reliance on the ED for health care


Interestingly half of the patients had been out of the drug for 10 or more days (were they waiting for a check so that they could pay for the drug?).

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