In California, adults with Medicaid coverage have highest increase in emergency department visits

"Emergency department (ED) use has been affected by insurance patterns over time and will likely be further affected by expansions of coverage from health care reform." Uninsured patients are often thought of as high and frequently inappropriate ED users, but insured patients, particularly those with Medicaid coverage, may have difficulties accessing primary care and may rely on EDs more frequently than uninsured patients, write Renee Y. Hsia, M.D., M.Sc., of the University of California, San Francisco, and colleagues in JAMA today.

In a Research Letter appearing in the September 18 issue of JAMA, the authors investigated recent trends in the association between insurance coverage and ED use. The study was a retrospective analysis of California ED visits by adults 19 to 64 years of age from 2005-2010 that used the nonpublic versions of data from the California Office of Statewide Health Planning and Development's Emergency Discharge Data and Patient Discharge Data. To study variations by insurance coverage, ED visits were grouped into 4 categories based on expected source of payment: Medicaid, private insurance, self-pay or uninsured, and other. The authors also looked at ED visits for ambulatory care sensitive conditions (ACSCs)

The researchers found that between 2005 and 2010, the number of visits to California EDs by adults overall increased by 13.2 percent from 5.4 to 6.1 million per year. The largest increase in visits occurred in 2009. The share of total visits increased among adults with Medicaid coverage and , whereas the share decreased among adults with private insurance. Visit rates to the ED among adult Medicaid beneficiaries were higher than uninsured and privately insured patients.

"Increasing ED use by Medicaid beneficiaries could reflect decreasing access to primary care, which is supported by our findings of high and increasing rates of ED use for ambulatory care sensitive conditions by Medicaid patients. The increase in ED visits was highest in 2009, likely due to the H1N1 pandemic and the influence of the economic downturn on coverage transitions and access to care," the authors write.

More information: doi:10.l001/ jama.2013.228331

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Even without kids, couples eat frequent family meals

1 hour ago

Couples and other adult family members living without minors in the house are just as likely as adults living with young children or adolescents to eat family meals at home on most days of the week, new research suggests.

Health law enrollment now 7.3M

14 hours ago

The Obama administration says 7.3 million people have signed up for subsidized private health insurance under the health care law—down from 8 million reported earlier this year.

ASTRO issues second list of 'Choosing wisely' guidelines

14 hours ago

(HealthDay)—The American Society for Radiation Oncology (ASTRO) has released a second list of five radiation oncology-specific treatments that should be discussed before being prescribed, as part of the ...

Bill Gates says progress made on new super-thin condom

16 hours ago

Billionaire philanthropist Bill Gates said Thursday progress is being made on developing a "next-generation" ultra-thin, skin-like condom that could offer better sexual pleasure, help population control and ...

User comments