More than one-third of patients who visit emergency rooms in the United States are uninsured, a problem expected to worsen for at least two more years, according to a new study of emergency physicians.
In a survey issued Wednesday by the American College of Emergency Physicians and the Robert Wood Johnson Foundation, 81% of doctors who work in hospital emergency departments say that uninsured ED patients are more likely to die earlier than patients with health insurance.
The two organizations presented their findings in conjunction with Cover the Uninsured Week, a national effort to bring attention to the estimated 41 million Americans without health insurance.
"That's a huge thing. To get 81% of physicians to agree on anything is remarkable," says Barbara LeTourneau, M.D., an emergency physician who is vice president for medical affairs at Regions Hospital in St. Paul, Minn., and a past president of the American College of Physician Executives.
The 1,321 physicians surveyed are nearly unanimous--93% to 97% in agreement--in saying the uninsured go to emergency departments first because they have difficulty accessing primary care, lack medications to control chronic diseases and have conditions that persist or worsen for lack of preventive care.
"A person who has a fever and a cough may not go get an antibiotic until they are sicker, until they develop something more severe like pneumonia and need to be admitted to a hospital" because costs are prohibitive, LeTourneau says.
Likewise, 93% of the ED practitioners say it is more difficult to arrange or secure follow-up care for uninsured patients with serious ailments than for similar people with coverage.
And 87% expect the volume of uninsured patients seeking emergency care to grow through at least 2005.
"When these patients are discharged from the hospital, they may need prescription drugs or follow-up care," LeTourneau says. Instead of paying for these services without the benefit of insurance, many "bounce right back into the hospital," she says.