ER referral ups specialist access for publicly insured

February 4, 2013
ER referral ups specialist access for publicly insured
Specialists are more willing to see publicly insured children if they are referred from an emergency department, according to research published online Jan. 10 in the Annals of Emergency Medicine.

(HealthDay)—Specialists are more willing to see publicly insured children if they are referred from an emergency department, according to research published online Jan. 10 in the Annals of Emergency Medicine.

Karin V. Rhodes, M.D., of the University of Pennsylvania in Philadelphia, and colleagues interviewed 26 specialists and 14 in Cook County, Ill., in an effort to better understand factors, including the role of referrals, influencing specialists' willingness to accept patients covered by Medicaid and the Children's (CHIP).

The researchers found that considerable barriers exist for primary care physicians to secure for publicly insured children and that the emergency department is used to facilitate this process. Many specialists reported being forced, due to economic concerns or institutional pressure, to limit the number of publicly insured pediatric patients they care for. Factors linked to specialist acceptance of patients with Medicaid/CHIP included high acuity or complexity, geography, patient hardship, and a personal request or an informal economic relationship with the primary care physician. For publicly insured patients, referral through the emergency department was a common and expected mechanism for access to specialty care.

"As our results show, inability to access specialty care can lead pediatric patients to the emergency department as well," the authors write. "Primary care providers and pediatric specialists alike acknowledged that using the emergency department as a 'middle-man' represents a viable 'work-around' in circumventing the access limitations faced by publicly insured children."

More information: Abstract
Full Text (subscription or payment may be required)

Related Stories

Medicaid patients go to ERs more often: study

March 19, 2012

(HealthDay) -- Medicaid patients have more difficulty getting primary care and visit hospital emergency departments more often than those with private insurance, a new study finds.

Recommended for you

New weapon in the fight against malnutrition

August 4, 2015

UBC scientists have opened the doors to new research into malnutrition by creating an animal model that replicates the imbalance of gut bacteria associated with the difficult-to-treat disease.

Can four fish oil pills a day keep the doctor away?

July 7, 2015

Fish oil is one of the most popular dietary supplements in the U.S. because of the perceived cardiovascular benefits of the omega-3 it contains. However, scientific findings on its effectiveness have been conflicting. New ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.