Presently, extensive research supporting the overcrowding of emergency departments (EDs) and behavior disorder patients presenting to EDs are prevalent. There exists a knowledge gap between specific behavior disorders diagnoses associated to repeated visits to the ED. The purpose of this quantitative study was to address whether a relationship exists between patients with psychotic and/or substance abuse disorders and the repeated ED visits within 72 hours. The Andersen Behavioral framework model and the secondary data were used in the study. The cross-sectional archival data from the 2016 National Ambulatory Medical Care Survey was analyzed by using cross-tabulation with the 2 test followed by multiple logistic regression analysis. The author found that the primary independent variables were not significant in (un)weighted multivariate results. However, the primary independent variables were statistically significant in the unweighted cross tabulation analyses, along with the covariates of homelessness, geographical region, and gender. The findings also showed a strong likelihood of return to the ED for the primary independent variables and covariates. The implications of this study with regard to social change and health care practices are providing proper outpatient resources through behavior disorder urgent care facilities, behavior disorder travel clinics, follow-up communications directly to the patients’ care managers, and creating a treatment team, which will decrease future financial effects on the healthcare system.

Master of Science / Department of Hotel, Restaurant, Institution Management & Dietetics / Ki-Joon Back / The objectives of this research were to address the impacts of positive and negative emotions on customers’ satisfaction and customers’ repeat visit intentions, and to investigate the mediating effect of customer satisfaction on the relationship between emotion and customers’ repeat visit intentions. A theoretical model of the formation of repeat visit intentions was proposed through a comprehensive review of the literature. Richins’ Consumption Emotion Set (1997) was modified to make it suitable for application in the lodging industry. The modifications were based on the participants’ responses to each emotion descriptor in the pilot test. Surveys were completed by graduate students and faculty members, undergraduate students at a Midwestern university, and conference attendees. Of 259 surveys returned, 248 responses were used for data analysis. Data were analyzed using factor analysis and a series of regression analysis. Positive and negative consumption emotions were found to have a significant effect on customer satisfaction and repeat visit intentions. Results also provided evidence of a significant association between customer satisfaction and repeat visit intentions. Customer satisfaction was found to be a full mediator in the relationship between customers’ positive and negative consumption emotions and repeat visit intentions. The loss aversion of the prospect theory was empirically supported in the formation of customers’ repeat visit intentions since results indicate that negative emotion has a greater influence on customer satisfaction and customers’ repeat visit intentions. Results support the importance of considering the impact of customers’ emotions on post-purchasing behaviors when developing better marketing and service strategies to achieve higher occupancy rate and retain customers.