Change in Health Insurance Status Linked to ER Use

Greater emergency department use for adults with recent change in health insurance status

WEDNESDAY, March 28 (HealthDay News) -- Recent changes in health insurance status are linked to greater emergency department use by newly insured and newly uninsured adults, according to a study published online March 26 in the Archives of Internal Medicine.

Adit A. Ginde, M.D., M.P.H., of the University of Colorado School of Medicine in Aurora, and colleagues analyzed data from 159,934 adult respondents to the National Health Interview Survey (2004 to 2009). Status of health insurance was categorized as newly insured (currently insured but lacked health insurance at some stage during the previous year); continuously insured; newly uninsured (currently uninsured but had health insurance at some stage during the previous year); and continuously uninsured.

The researchers found that 29.5 percent of newly insured adults had at least one emergency department visit, compared with 20.2 percent of continuously insured adults. Compared with 18.6 percent of continuously uninsured adults, 25.7 percent of newly uninsured adults had at least one emergency department visit. After adjusting for sociodemographics and health status, a recent change in health insurance status independently correlated with increased emergency department use for newly insured adults (incidence rate ratio [IRR], 1.32) and newly uninsured adults (IRR, 1.39), compared with continuously insured and continuously uninsured, respectively. Among the newly insured, this correlation was strongest for Medicaid beneficiaries (IRR, 1.45) and weaker, but still significant, for those with private insurance (IRR, 1.24).

"Recent changes in health insurance status for newly insured adults and for newly uninsured adults were associated with greater emergency department use," the authors write.

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