Study: Most Medicaid Beneficiaries Not Going to EDs for Routine Care
A majority of Medicaid beneficiaries' visits to hospital emergency departments are for urgent care, rather than for routine care, according to a study released Wednesday by the Center for Studying Health System Change, the Washington Post reports (Kliff, Washington Post, 7/11).
The study, funded by the Robert Wood Johnson Foundation, was intended to better understand how the non-elderly Medicaid population's use of EDs compares with individuals who are privately insured (Reichard, CQ HealthBeat, 7/11).
Researchers said their findings dispel the idea that low-income patients are overcrowding EDs by seeking routine care at EDs, rather than at community clinics or physician's offices (Heavey, Reuters, 7/11).
For the study, researchers used data from the National Hospital Ambulatory Medical Care Survey, which collates information about visits to EDs nationwide. They analyzed 34,134 ED visit records in 2008, the most recent year for which data are available, the Post reports (Washington Post, 7/11).
The study found that about 10% of ED visits by non-elderly Medicaid beneficiaries were for routine care, while about 7% of visits by privately insured individuals were for routine care (CQ HealthBeat, 7/11). Three-quarters of visits by Medicaid beneficiaries were classified as emergent, urgent or semi-urgent, while 78% of visits by privately insured patients fell under one of the three categories (Washington Post, 7/11).
Researchers noted that like most other patients, Medicaid beneficiaries visit EDs for urgent complaints of injuries and potentially serious problems, such as high fevers and breathing difficulties (Reuters, 7/11).
The study noted that Medicaid beneficiaries tend to face a greater need for emergency care at a rate of 5.6 visits per 100 beneficiaries, compared with 3.6 visits per 100 privately insured individuals (CQ HealthBeat, 7/11). Researchers attributed the higher dependence on EDs to the fact that Medicaid beneficiaries generally are sicker than individuals with private insurance (Sanger-Katz, National Journal, 7/11).
The study also identified ways that ED use could be reduced, CQ HealthBeat reports.
Researchers suggested expanding opportunities to provide prompt treatment at lower costs in alternative care settings, and ensuring that appropriate services and equipment are available to diagnose and treat minor ailments (CQ HealthBeat, 7/11).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.