Study: Uninsured patients aren't overusing the ER — 4 things to know

Uninsured adults use emergency rooms at similar rates to insured adults, contrary to popular perception, according to a recent Health Affairs study.

The study gathered data from the 2013 Medical Expenditure Panel Survey to analyze how often insured and uninsured adults ages 19–64 used different types of care, which included emergency department visits, outpatient visits and hospital admissions.

To analyze different types of ED visits according to patients' insurance status, researchers used data from the 2013 National Hospital Ambulatory Medical Care Survey, which provided a nationally representative sample of electronic patient records.

Here are four findings from the study:

1. Researchers found uninsured adults go to the ER about as much as people with private insurance. Approximately 12 percent of the uninsured went to the ER in 2013 compared to about 11 percent of the privately insured and around 29 percent of people on Medicaid.

2. Uninsured adults receive outpatient care less frequently. Nearly 77 percent of adults with private insurance used outpatient services, compared with approximately 75 percent of adults with Medicaid and nearly 42 percent of uninsured adults in the same year.

3. Although EMTALA provides the uninsured with a legal right to care through the ED, uninsured adults might be legally denied care in non-ED settings, according to the authors. Poor populations who are insured and uninsured often face several non-financial barriers to healthcare access, which include factors such as stigma, difficulty finding and building relationships with providers, and confusion about insurance benefits or the cost of care.

4. The study shows uninsured adults use other types of care such as outpatient visits or hospitalizations much less than the insured. As a result, uninsured patients are most likely encountered in the ED, which may contribute to the common misperception that the uninsured use the ED more than the insured.

More articles on EDs: 
ACEP responds to Vox analysis on ER billing practices
Cape Cod firm develops software to track ambulance patients
New York hospital unveils ED as part of $90M expansion

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