NCPA - National Center for Policy Analysis

MOST ER PATIENTS ARE INSURED

March 31, 2006

Challenging a common notion that uninsured patients are clogging hospital emergency rooms, a new study has found that the vast majority of adults who turn up there frequently have health insurance and regular doctors.

The finding suggests that expanding health coverage will not by itself significantly help emergency rooms cope with demands that include patients seeking care for routine problems such as colds or sinus infections, say experts.

The study was conducted by researchers with the Robert Wood Johnson Foundation and UC San Francisco. They studied survey responses from 32,669 households across the country in 2001. The researchers found:

  • The uninsured account for just 15 percent of emergency-room visits. Emergency rooms are crowded because they fill up with patients who cannot get in to see their own doctor or are waiting for regular hospital beds.
  • About 45 million American adults made a total of 80 million visits to emergency rooms between July 2000 and June 2001.
  • Frequent emergency-room users -- those who visited emergency departments four or more times a year -- represented less than a tenth of all emergency users yet accounted for 28 percent of all visits.
  • About 84 percent of frequent emergency-room users had health insurance and 81 percent had a source of primary health care either through a doctor or a clinic. About half had government-subsidized health plans like Medicaid or Medicare, while a third had private plans.

Health care providers assumed until recently that uninsured patients were the primary cause of crowding, says Diane Jacobsen, a director at the Institute for Healthcare Improvement in Cambridge, Mass., who did not participate in the study. Most doctors are free to turn away patients who cannot pay, but emergency-room doctors must see everyone.

Source: Daniel Yi, "Most ER Patients Are Insured, Study Says; The uninsured, long blamed for crowding in the emergency room, account for 15% of visits," Los Angeles Times, March 29, 2006.

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