The rise in emergency department (ED) visits between 1996 and 2003 cannot be primarily attributed to the uninsured, according to a study report published in the April issue of Annals of Emergency Medicine. Instead, major contributors to increasing ED utilization appeared to be a rise in use by nonpoor patients and by patients whose usual source of care is a physician’s office.
Those were among the surprising findings of a study by University of California, San Francisco, researchers who examined national Community Tracking Study Household Surveys. Their analysis revealed that, while the proportion of adult ED visits by the uninsured was stable across that period of time, the proportion of visits by patients whose family income was greater than 400 percent of the federal poverty level increased from 21.9 percent to 29.0 percent. Also, the proportion of ED visits by those whose usual source of care was a physician’s office increased from 52.4 percent in 1996-97 to 59.0 percent in 2003-04.
“Together, these findings suggest that the rise in ED use is disproportionately due to nonpoor individuals who have a usual source of health care,” write the researchers. “These findings have significant implications for current policy discussions because they suggest that the provision of health insurance will not, in and of itself, address issues of ED crowding or the more general issues of access to, and appropriateness of, healthcare services.” Read the article.
