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Most people who go to hospital emergency departments (EDs) have medical insurance and a primary care provider, according to a new report. This contradicts the assumption that poor, uninsured patients are filling the nation's EDs.


In a population-based national study, researchers analyzed interviews of nearly 50,000 adults who visited EDs in 2000 and 2001. They found that 83% had a primary care physician. Eighty-five percent had health insurance (the same percentage of people with medical coverage nationwide), and 79% had incomes above the poverty level.


People without health insurance weren't any more likely to visit the ED than people with insurance, the researchers found. In fact, people who didn't have a primary health care provider were 25% less likely to visit the ED than those with a regular source of health care.


The researchers concluded that ED users and nonusers are similar with respect to health insurance and their usual source of health care, but that ED users are more likely to be in poor health and to have experienced disruptions in their usual source of care (for example, because of changes in insurance coverage). To ease the burden on EDs, they recommend improving delivery of outpatient care.




Does lack of a usual source of care or health insurance increase the likelihood of an emergency department visit? Results of a national population-based study, Annals of Emergency Medicine, EJ Weber, et al., article in press; available online.