ER Use Up With Health Care Reform in Massachusetts

Consistent increase in emergency department use in within-reform and post-reform periods

WEDNESDAY, April 2, 2014 (HealthDay News) -- Implementation of health care reform in Massachusetts was associated with an increase in emergency department use, according to a study published online March 24 in the Annals of Emergency Medicine.

Peter B. Smulowitz, M.D., M.P.H., from the Beth Israel Deaconess Medical Center in Boston, and colleagues examined the extent to which Massachusetts health care reform (implementation started in 2006) correlated with changes in emergency department utilization. Emergency department utilization changes were compared for individuals from areas of the state that were minimally affected by health care reform versus those from areas that were most affected. In addition, changes in emergency department utilization were compared for those younger than 65 years and for those aged 65 years or older. Analyses included 13.3 million emergency department visits during 2004 to 2009.

The researchers found that emergency department use increased with increasing insurance coverage in Massachusetts. This association was consistent across all specifications and in both age groups. Compared with the pre-reform period, the implementation of health care reform correlated with a 0.2 to 1.2 percent increase in emergency department visits per year within-reform and a 0.2 to 2.2 percent increase post-reform.

"The implementation of health care reform in Massachusetts was associated with a small but consistent increase in the use of the emergency department across the state," the authors write.

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