Who's packing ERs? Not the uninsured

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bravotwozero

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Who's packing ERs? Not the uninsured
Wed, May 19 2010

WASHINGTON (Reuters) - One in five people in the United States visit an emergency room every year, and most of them have health insurance of some kind, according to a U.S. government survey released on Wednesday.

The survey contradicts a common perception that emergency rooms are packed with uninsured people and illegal immigrants. It also rejects some claims that people are using the emergency department for routine care -- just 10 percent of visits were for non-urgent causes.

"In 2007, approximately one in five persons in the U.S. population had one or more emergency department visits in a 12-month period," the report from the National Center for Health Statistics reads.

"Among the under-65 population, the uninsured were no more likely than the insured to have had at least one emergency department visit in a 12-month period."

Tamyra Carroll Garcia and colleagues at the center used two large national surveys of healthcare use in 2007 for their study.

"Since 1996, demand for emergency services in the United States has been rising," they wrote.

"While the number of emergency departments (EDs) across the country has decreased, the number of ED visits has increased. As a result, EDs are experiencing higher patient volume and overcrowding, and patients seeking care are experiencing longer wait times," they added.

"As national health care costs continue to rise and policymakers become increasingly interested in ways to make the health care system more efficient, it is important to understand the characteristics of those individuals who use EDs -- often in place of other sources of ambulatory care."

They found that the more income people had, the less likely they were to ever visit an emergency room. People over 75 and blacks were the most likely to visit emergency rooms.

The American College of Emergency Physicians published a survey this month showing that 61 percent of emergency doctors surveyed believe U.S. healthcare reform will send even more people to emergency departments.

Only 1 percent of the 1,800 doctors surveyed thought visits would decrease. And 47 percent said the reforms signed into law in March would worsen overcrowding in emergency rooms.

"It's important to note the report finds that having a usual source of medical care, such as a primary care provider, does not affect the number of times people under age 65 visit the emergency department," Dr. Angela Gardner, president of the American College of Emergency Physicians, said of Wednesday's report.

Reuters
 
There have been a number of studies on this over the past few years such as this one. We've had several threads on it although I can't find any of them because searching terms like "uninsured" comes up with a lot of threads.

While it's unfashionable to argue against data with experience I have some issues with these studies. I think that many of the groups releasing these studies including ACEP have political agendas.

EPs have an interest in changing the reputation of EDs as somewhere where the uninsured go to get care. If we can convince administrators that the ED can be a money maker it will be to our benefit.

Many national groups favor universal care. The anger generated in the general public when they hear that the uninsured drive up the cost of emergency care generally results in more backlash than warm fuzzies.
 
One thing that keeps a lot of the uninsured away is the cost. The responsible ones who worry about their credit scores don't want to spend money on an ER visit.

Give them Medicaid, or insurance and now there's an incentive to get medical care.

Massachusetts found this out with their own comprehensive "Romney-Care" bill. ED visits increased 11% since extending coverage to all.

Apparently this data was ignored by those in favor of the national healthcare bill, or they were engaged in magical thinking of "cutting costs".
 
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