# EMERGENCY DEPARTMENT UTILIZATION BY SPINA BIFIDA PATIENTS IN FLORIDA 2016–2020

## TL;DR

This study found that young adults with spina bifida use emergency departments most frequently in Florida, often for preventable issues like infections and seizures.

## Contribution

The study identifies the transitional age group (20–29) as having the highest emergency department utilization for spina bifida patients, emphasizing the need for coordinated care during this period.

## Key findings

- Transitional age group (20–29) had the highest emergency department encounters (24.1%).
- Infections (23.1%) and epilepsy/seizure (17.3%) were the most common presenting diagnoses.
- Transitional group had significantly more encounters than other age groups (p < 0.001).

## Abstract

To investigate emergency department use of spina bifida patients in Florida and identify presenting diagnoses across all age groups.

Retrospective cohort study.

Individuals with a diagnosis of spina bifida who presented to the emergency department between 2016 and 2020 in Florida.

The State Emergency Department Databases of Florida from the Healthcare Cost and Utilization Project were utilized. Principal diagnosis codes were queried, and patients were classified into paediatric (ages 0–19), transitional (ages 20–29), adults (ages 30–59), and geriatric (ages 60 or greater). To analyse patient-level factors and observed case numbers, χ2 testing was used. The transitional period was further evaluated by pair-wise tests of proportions with Bonferroni adjustment.

The transitional age group (20–29) patients had the highest number of emergency department encounters (24.1%). The most common presenting diagnoses were infections (23.1%) followed by epilepsy and seizure (17.3%). Transitional groups were responsible for the most emergency department encounters across all categories (p < 0.001).

Transitional ages patients (20–29) were responsible for the majority of encounters, suggesting the significance and the need for continued multidisciplinary coordinated care during the transitional of care between paediatric and adult settings for patients with spina bifida.

Spina bifida is a congenital condition in which a patient’s spinal column does not close properly before birth, leading to a significant effect on movement, sensation, and organ function. Due to the involvement of multiple organ systems, patients require specialized medical care throughout their lives. In the United States, most paediatric patients can receive care in multidisciplinary clinics or paediatric hospitals. Unfortunately, adult patients with spina bifida often encounter challenges accessing such care. This can lead to an increased reliance on the emergency department for conditions that otherwise may be treated in a primary care setting or even prevented. This study aimed to evaluate emergency department utilization by spina bifida patients in Florida and to investigate the common presenting diagnoses across their lifetime. Many visits were for preventable conditions. This highlights the need for access to quality primary and specialty care across all ages, especially during the transition of care.