Date

12-4-2025

Department

School of Health Sciences

Degree

Doctor of Philosophy in Health Sciences (PhD)

Chair

Chloe Fields

Keywords

opioids, access to health care, primary health care, emergency department, rural, urban

Disciplines

Medicine and Health Sciences

Abstract

The overuse of emergency department (ED) services presents challenges for hospitals and communities as valuable resources are funneled repeatedly into the same patients. Frequent ED users account for a significant portion of used resources, and efforts have been made to address this public health concern. This paper sought to identify associations between opioid administration and access to a PCP in one rural and one urban hospital in Arkansas. Through an investigation of 200 medical records of ED users identified as frequent users of one rural (n=100) and one urban (n=100) hospital between 2018 and 2023, the researcher identified associations between opioid administration and access to a primary care provider. A descriptive correlational research design was used, and the variables were analyzed to identify the associations with one another in the study population using Fisher’s Exact Test. Based on the p-value being greater than 0.05, no associations were found between opioid administration and access to a PCP for either the rural (p=.792) or urban (p=0.256) hospitals. No interactions between opioid administration and access to a PCP were noted for patients at a rural or urban hospital in Arkansas for this study. While the findings show no relationship, other factors might have had a complex relationship that confounded the findings from this study, so future studies are necessary. Using this research and other future research, policies and interventions can be developed to specifically address the factors that were associated with one another as the factors relate to frequent ED users. The Health Equity Framework was used as a theoretical framework for this quantitative study.

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