Disparities in treatment of children in the emergency department based on their insurance status

May 10, 2012, Elsevier

In 2009, children with public insurance were three times more likely and children with no insurance were eleven time more likely not to have a primary care physician, compared with children with private insurance. Without a primary care physician, the Emergency Department (ED) often becomes the primary point of contact for treatments and diagnoses. A new study scheduled for publication in The Journal of Pediatrics reports that children with private, public, and no insurance may receive differing levels of treatment in EDs.

Rebekah Mannix, MD, MPH, and colleagues from Children's Hospital Boston, retrospectively assessed 84,536 ED visits of children ≤18 years of age in 1999-2008, using the National Hospital Ambulatory Medical Care Survey, which is an annual survey of ~480 hospital EDs. Over the 10-year period, researchers found that 45% of children in the ED had private insurance, 43% had public insurance (Medicaid or State Children's Health Insurance Program), and 12% had no insurance. Compared with children with private insurance, those with public or no insurance were almost 25% less likely than those with private insurance to undergo testing, receive a medication, or undergo any procedure when seeking care in the ED. Although children with were 20% more likely to be diagnosed with a significant illness compared with children with private insurance, there was no difference in the level of treatment based on insurance status among children with significant illnesses.

It is unclear whether these insurance-based differences represent under treatment in children without private insurance, over treatment in children with , or appropriate care for all. Dr. Mannix reminds us that "because ED physicians are salaried or paid by the hour, it is uncertain how or why a child's insurance status could be associated with care decisions in the ED." Although the authors speculate that the disparities could be due to a variety of reasons, they note that further studies are needed to assess insurance-associated outcomes.

Explore further: Children with public health insurance less likely to receive comprehensive primary care

More information: “Insurance Status and the Care of Children in the Emergency Department” by Rebekah Mannix, MD, PhD, Vincent Chiang, MD , and Anne M. Stack, MD, appears in The Journal of Pediatrics, DOI 10.1016/j.jpeds.2012.03.013

Related Stories

Children with public health insurance less likely to receive comprehensive primary care

July 15, 2011
Children with public insurance are 22 percent less likely to receive comprehensive primary care than those with private insurance, according to new research from the University of Michigan Medical School.

Families shifting from private to public health insurance for children: study

July 27, 2011
Families are increasingly relying on public health insurance plans to provide coverage for their children, a growing trend that researchers say is tied to job losses, coverage changes to private health insurance plans, and ...

Better short-Term outcomes for private prostatectomies

March 30, 2012
(HealthDay) -- For men undergoing radical prostatectomies (RPs), private health insurance coverage is linked with fewer complications, less in-hospital recovery time, and decreased mortality, compared to public coverage, ...

Higher Medicaid payments to dentists associated with increased rate of dental care among children

July 12, 2011
Children and adolescents from states that had higher Medicaid payment levels to dentists between 2000 and 2008 were more likely to receive dental care, although children covered by Medicaid received dental care less often ...

Recommended for you

Placental accumulation of flame retardant chemical alters serotonin production in rats

January 22, 2018
A North Carolina State University-led research team has shown a connection between exposure to a widely used flame retardant chemical mixture and disruption of normal placental function in rats, leading to altered production ...

Marijuana use does not lower chances of getting pregnant

January 22, 2018
Marijuana use—by either men or women—does not appear to lower a couple's chances of getting pregnant, according to a new study led by Boston University School of Public Health (BUSPH) researchers.

Americans are getting more sleep

January 19, 2018
Although more than one in three Americans still don't get enough sleep, a new analysis shows first signs of success in the fight for more shut eye. According to data from 181,335 respondents aged 15 and older who participated ...

Wine is good for you—to a point

January 18, 2018
The Mediterranean diet has become synonymous with healthy eating, but there's one thing in it that stands out: It's cool to drink wine.

Sleep better, lose weight?

January 17, 2018
(HealthDay)—Sleeplessness could cost you when it's time to stand on your bathroom scale, a new British study suggests.

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

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.