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Shifts in coverage status tied to ER use: study


By Melanie Evans
Posted: March 26, 2012 - 4:00 pm ET
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Adults who recently gained or lost health insurance were more likely to visit the emergency room than those continuously insured or uninsured, newly published research said.

The paper, published in the Archives of Internal Medicine, suggests that economic forces or public policy that can affect insurance status could lead to greater emergency room use, wrote physician researchers Adit Ginde, Robert Lowe and Jennifer Wiler.

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The newly insured were defined as those with insurance but who lacked coverage during the prior year. Newly uninsured had no coverage at some point during the prior year.

The newly insured used the emergency room about 32% more than those who were insured for the entire prior year, the research found. Researchers used National Health Interview Survey data from 2004-09 for the analysis. The newly uninsured used the emergency room about 39% more than the continuously uninsured.

Ginde, Lowe and Wilder suggested that lack of access to primary care could result in the higher emergency room use among those “churning” from uninsured to insured and vice versa.

The newly insured may have deferred treatment when uninsured and may continue to struggle to find primary-care access, the researchers said. The newly uninsured “may experience a sudden decrease in access to care and require EDs for medical services,” the paper said.

Healthcare providers should also expect more emergency room demand, the researchers said. “Although in our study only 7.8% of U.S. adults had changes in health insurance status during the prior 12 months, legislative and economic factors are poised to increase the frequency of recent gain or loss of insurance,” they wrote.


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