UNINSURED ADOLESCENTS: Rely On ERs For Non-Urgent Care
A new study finds that a large percentage of uninsured adolescents turn to hospital emergency rooms for non-urgent care. Appearing in the current issue of Pediatrics, the study was led by the University of Pennsylvania School of Medicine's Dr. Amitai Ziv and is based on data from the 1994 National Hospital Ambulatory Medical Care Survey conducted by the National Center for Health Statistics. The researchers found that 26.2% of adolescents ages 11 to 21 who visited ERs in 1994 were uninsured, compared to only 13.6% of children under 11. The researchers also found that the "rate of public insurance was higher among adolescents visiting emergency departments than in the general adolescent population (27% vs. 10%), whereas the rate of private insurance was lower (46% vs. 73%)." Fifty-three percent of adolescent ER visits were either uninsured or covered by public programs in 1994. Overall, "[u]tilization of emergency departments increases and health insurance decreases during adolescence," the study found. The authors cite other data that shows "adolescents are more likely to be uninsured and less likely to utilize office-based health services than any other age group in the United States."
The researchers found that most adolescent patients seeking ER care did not require hospitalization and that half of these visits were not for urgent conditions, "suggest[ing] that many adolescents do indeed use emergency departments for primary health care." In their conclusion, the researchers write: "The policy implications of these findings are clear. Adolescents must have access to health insurance and primary care services. Only then will adolescents and health care providers shift from a model of crisis intervention to one of anticipatory guidance, screening, and primary prevention" (Ziv et al, June issue). Click here to see an abstract of the study.