Some 85% of people using hospital emergency departments had medical insurance, 83% had a usual source of healthcare and 79% had incomes that exceeded the poverty threshold, according to a new study. The findings run counter to conventional wisdom that the poor and uninsured dominate the nation's overcrowded emergency rooms. Instead, poor health drives ER utilization, said the study's lead author, Ellen Weber, a physician and professor of clinical medicine in the division of emergency medicine at the University of California, San Francisco. The study was the first large-scale survey of its kind, involving interviews with nearly 50,000 adults between 2000 and 2001. It was released as an early online publication of the Annals of Emergency Medicine.
"Contrary to popular perception, individuals who do not have a usual source of care are actually less likely to have visited an emergency department than those who have such care," Weber said. She said the study's findings show that ERs serve as a safety net "not just for the poor and uninsured, but for mainstream Americans, and in particular those with serious and chronic illness." A May study by the Centers for Disease Control and Prevention, based on a 2000 federal survey and Medicaid disproportionate-share payments, found that about 36% of U.S. ERs served a disproportionately high number of Medicaid or uninsured patients. The latest study is available for purchase or free to American College of Emergency Physicians members and Annals subscribers at elsevierhealth.com. -- by Michael Romano