Abstract
Background
Approximately 21 million persons have diabetes and account for 11.9% of all emergency
department (ED) visits for a total cost of $14.1 billion. Nonemergent visits for ambulatory-sensitive
conditions that could be managed by the primary care provider make up almost one-third
of the ED visits. African Americans comprise approximately 30% of South Carolina׳s
population but make up approximately 50% of the ED visits for diabetes. The purpose
of the research was to explore the experiences of 20 African-American adults with
diabetes with ambulatory-sensitive ED use.
Research Design and Methods
The research design for this study is grounded theory with dimensional analysis methods.
Following ethics approval and informed consent, interviews were conducted, recorded
and transcribed verbatim, and themes were analyzed to form the explanatory framework
or matrix for ED use. The framework of context, conditions, processes and consequences
provides a key for understanding the themes of the story embedded in the descriptive
narratives.
Results
The contested ownership of diabetes was the overarching perspective—“doing what I
got to do,” “it׳s always on mind… wishing not to be a diabetic” and “it׳s a constant
burden.” And handling diabetes involved taking decisions “into your hands.” The context
of perceived urgency of symptoms included all the reasons that precipitated ED visit—personal
experience, primary care access and services and social network support for decisions-influenced
ownership of these decisions.
Key Indexing Terms
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Article info
Footnotes
☆The authors have no financial or other conflicts of interest to disclose.
These authors contributed equally to this work.
Identification
Copyright
© 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
