During a period in which the number of emergency department visits rose significantly, the proportion of uninsured patients visiting emergency departments dropped slightly, while visits by affluent patients and those who usually get care in a doctor’s office rose sharply, according to a study published online in the Annals of Emergency Medicine.
Researchers analyzing data from the Community Tracking Study Household surveys found that uninsured people accounted for 15.5% of emergency department visits in 1996-1997, but only 14.5% of visits in 2003-2004. In the same period, the proportion of visits by higher-income people (equal to or greater than 400% of the federal poverty level) increased from 21.9% to 29%.
The proportion of visits by those whose usual source of care was a physician’s office climbed from 52.4% to 59%. Overall emergency department visits rose from 90.3 million in 1996 to 113.9 million in 2004, an increase of 26%.
The study is titled “Are the Uninsured Responsible for the Increase in Emergency Department Visits in the United States?”
Ellen J. Weber, MD, University of California, San Francisco, the lead study author noted the findings may portend potential policy implications.
“If the rise in visits is inappropriately attributed to the uninsured, programs to reduce emergency department crowding may be misdirected and fail to address its real underlying causes,” she said, adding that emergency departments act serve as safety nets for all patients.
She said the overall rise in emergency department use can probably be attributed to a complex set of structural problems in the health care system, and innovative solutions are needed to solve the problem of emergency department crowding, which hampers access to care for everyone.
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, Dallas, a national medical society with more than 25,000 members.
