PEOPLE IN PUBLIC PROGRAMS MORE LIKELY TO USE EDs

Volume 29, Issue 507 January 22, 2008

Matthew Gever

Publicly insured persons are more likely to go to emergency departments for care than are privately or even uninsured ones, according to a new backgrounder from the Heritage Foundation.

Since the early 1990s, the number of annual ED visits has increased by 18 percent, while the overall number of emergency departments and available beds has declined. Most of this rise, according to the memo, is from patients who have public rather than private insurance. For example, Medicaid and SCHIP enrollees visited EDs at four times the rate of privately insured patients and twice the rate as those with no insurance.

Many of the visits were for non-emergency conditions. A study from Maryland, for example, found that non-urgent medical problems accounted for 40 percent of ED visits. The overcrowding—and decrease in the number of—EDs could pose significant dangers in times of crisis, such as an outbreak or a terrorist attack.

Heritage suggests a number of ways to reduce the burden on emergency departments, ranging from expanding premium support programs to promoting private-sector alternatives for urgent care.

Public use of EDs

ER use rising while number of hospitals falling