Most ER Patients Are Insured, Study Says | LAT | 3.29.06
Challenging a common notion that uninsured patients are clogging hospital emergency rooms, a new study has found that the vast majority of adults who turn up there frequently have health insurance and regular doctors.
The finding suggests that expanding health coverage will not by itself significantly help emergency rooms cope with demands that include patients seeking care for routine problems such as colds or sinus infections, experts said.
Being Back in E.R. May Not Mean No Insurance | NYT | 4.4.06
People who frequent emergency rooms are widely assumed to be there because they lack insurance, the implication being that their complaints are too minor to take up the E.R.’s valuable time.…
The study found that 84 percent of the frequent users had insurance and that 81 percent had regular health providers.
Although the study found that frequent emergency room visitors often had good reason to be there, it suggested that that there were better ways to take care of their needs.
Frequent Emergency Department Users Are not Abusers, Study Finds | ACEP | 3.29.06
Washington, DC - Debunking common misconceptions about frequent emergency department users is the subject of new research published online today by Annals of Emergency Medicine. The study finds these emergency patients are insured, have a usual source of health care, and are more likely than less frequent users to be in poor health and require constant medical attention (Characteristics of Frequent Users of Emergency Departments).
“Frequent users are heavily studied in the medical literature, in part because of the presumption that they contribute substantially to emergency department overcrowding and that their use is inappropriate,” said lead author Kelly Hunt, MPP, with the Robert Wood Johnson Foundation in Princeton, N.J.
Contrary to common conceptions, frequent users of emergency medical care are insured (84 percent) and have a usual source of health care (81 percent) such as a primary care physician. “Although its often thought that those who use the ED more frequently do so because they don’t have a primary care provider, we found people who lack a usual source of health care were less likely to be frequent users of emergency departments,” said Hunt. “But frequent users were more likely to be in poor physical and mental health and to be frequent users of other parts of the health care system. Additionally, frequent users were more likely to be poor and to be dissatisfied with their overall health care.”
Using a national household survey designed to track changes in the United States’ health care system and their effects, the researchers from Robert Wood Johnson Foundation and the University of California San Francisco found that frequent users of emergency departments, which these researchers define as an adult who made four or more emergency visits in one year, comprised only 8 percent of emergency department users and were responsible for 28 percent of all adult visits.
About 45 million adults made one or more emergency department visits between 2000 and 2001, according to the national household survey. The vast majority (92 percent) of adult emergency patients made three or fewer visits, accounting for 72 percent of adult emergency department visits.
“It’s generally assumed that ‘frequent’ emergency department use is the same as ‘inappropriate’ use,” said Hunt. “Because frequent users are sicker than less frequent users, and appear to have more health care visits in other parts of the health care system, it appears that these emergency visits are actually appropriate for these individuals to obtain needed care.”
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, a national medical society with more than 23,000 members. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information visit www.acep.org.
Does lack of a usual source of care or health insurance increase the likelihood of an emergency department visit? Results of a national population-based study | AEM | January 2005
Weber EJ, Showstack JA, Hunt KA, Colby DC, Callaham ML
Ann Emerg Med January 2005 (Vol. 45, Issue 1, Pages 4-12)Conclusion
ED users are similar to nonusers with regard to health insurance and usual source of care but are more likely to be in poor health and have experienced disruptions in regular care. The success of efforts to decrease ED use may depend on improving delivery of outpatient care.
Characteristics of Frequent Users of Emergency Departments (Corrected Proof) | AEM | March 2006
Hunt KA, Weber EJ, Showstack JA, Colby DC, Callaham ML
Ann Emerg Med March 30, 2006Conclusion
The majority of adults who use the ED frequently have insurance and a usual source of care but are more likely than less frequent users to be in poor health and require medical attention. Additional support systems and better access to alternative sites of care would have the benefit of improving the health of these individuals and may help to reduce ED use.