ER referral ups specialist access for publicly insured

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)

add to favorites email to friend print save as pdf

Related Stories

Medicaid patients go to ERs more often: study

Mar 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

Sensors may keep hospitalized patients from falling

8 hours ago

(Medical Xpress)—To keep hospitalized patients safer, University of Arizona researchers are working on new technology that involves a small, wearable sensor that measures a patient's activity, heart rate, ...

Rising role seen for health education specialists

10 hours ago

(HealthDay)—A health education specialist can help family practices implement quality improvement projects with limited additional financial resources, according to an article published in the March/April ...

User comments