Managed Care

 

Privately Insured Use Emergency Room Less

MANAGED CARE December 2007. © MediMedia USA
News and Commentary

Privately Insured Use Emergency Room Less

MANAGED CARE December 2007. ©MediMedia USA

A recently issued brief from the Henry J. Kaiser Family Foundation seeks to characterize and analyze persons who frequently, or infrequently, use hospital emergency departments (EDs). The report, titled “Characteristics of Frequent Emergency Department Users,” found that frequent users, those who had four or more visits over two years, often belong to groups with greater need for health care services: the elderly, the poor, and persons living with chronic conditions, all of whom are likely to be in poor health.

High ED users are far more likely to have Medicare (28 percent) or Medicaid (23 percent) coverage than low ED users (18 percent and 12 percent, respectively) and non-ED users (12 percent and 8 percent, respectively).

In contrast, a majority of both low ED users (54 percent) and non-ED users (64 percent) have private health insurance coverage.

In addition, there is little variation between ED user groups in terms of the proportion without insurance, with 14 percent of low ED users, 15 percent of non-ED users, and 17 percent of high ED users lacking insurance.

When comparing the ED visits of different health insurance groups, Eric Becker and Bianca DiJulio, researchers at Kaiser, found that the uninsured are no more likely to use the ED frequently than are others.

They report a consistently different pattern of ED use. Medicaid and Medicare beneficiaries are typically ED users at rates exceeding the group average, the privately insured are consistently below average, and the uninsured are near the average.

The uninsured, while making up roughly 15 percent of the sample population, account for about 14 percent of total ED visits and less than 12 percent of aggregate ED expenses.

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