Visits to ERs Increasing; Medicaid May Be Playing Role

Adults with Medicaid account for much of increase in visits; 'safety net' function seen for ERs
By Eric Metcalf
HealthDay Reporter

TUESDAY, Aug. 10 (HealthDay News) -- Rates of emergency department visits increased during a recent 10-year period, with findings suggesting that emergency departments are growing in importance as a safety net for adults with Medicaid and other underserved patients, according to research published in the Aug. 11 issue of the Journal of the American Medical Association.

Ning Tang, M.D., of the University of California in San Francisco, and colleagues analyzed data on emergency department visits from the National Hospital Ambulatory Medical Care Survey from 1997 through 2007.

The researchers found that, during this period, visit rates to emergency departments rose from 352.8 to 390.5 per 1,000 people, which was an increase in total annual visits that was nearly twice what would have been expected from population growth. Adults with Medicaid made up most of the growth in emergency department visits, with a visit rate increasing from 693.9 to 947.2 visits per 1,000 enrollees from 1999 to 2007. In adults with Medicaid, the visit rate for ambulatory care-sensitive conditions per 1,000 enrollees rose from 66.4 to 83.9 from 1999 to 2007. Facilities meeting the criteria for "safety-net" emergency departments -- based on caseload of patients who are uninsured or on Medicaid -- rose from 1,770 in 2000 to 2,489 in 2007.

"Regardless of the future of health care after implementation of the Patient Protection and Affordable Care Act, a robust safety-net system may offer the best chance of providing quality care to those excluded from health reform and those who newly acquire health insurance," concludes the author of an accompanying editorial.

The editorial author disclosed a financial relationship with Health Management Associates.

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