Emergency rooms not filled with the uninsured

[jamesinca]

I found this article tonight, it is research but out there none the less. It blows holes in the argument that the poor are the ones that are filling the E.R. Here is the abstract. No link, but it can be searched by the source below using the periodical title.
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Study objective We determined whether having a usual source of care or health insurance is associated with the likelihood of an emergency department (ED) visit.

Methods This was a multivariate analysis of the 2000 to 2001 nationally representative Community Tracking Study Household Survey to assess the independent association of usual source of care, health insurance, income, and health status with the likelihood of making 1 or more ED visits in the previous year.

Results Based on a sample of 49,603 adults, an estimated 45.3 million adults reported 79.6 million ED visits in the previous year; 83.1% of these visitors identified a usual source of care other than an ED. Persons with poor physical health status made 48.4% of visits. Adults without a usual source of care were less likely to have had an ED visit than those whose usual source of care was a private physician (odds ratio 0.75). Uninsured individuals were no more likely to have an ED visit than insured individuals. Poor physical health (OR 2.41), poor mental health (OR 1.51), 5 or more outpatient visits during the year (OR 4.05), and changes in insurance coverage (OR 1.14) or usual source of care (OR 1.32) during the year were associated with an ED visit. Enrollment in a health maintenance organization and satisfaction with one's physician were not independently associated with ED use.

Conclusion ED users are similar to nonusers with regard to health insurance and usual source of care but are more likely to be in poor health and have experienced disruptions in regular care. The success of efforts to decrease ED use may depend on improving delivery of outpatient care.
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Annals of Emergency Medicine; Weber, E.J. et al, January 2005, Vol 45, Number 1.

[liberalnurse]

1. One would think they would

actually get their data from the hospital emergency departments. Adults will basically lie.

[jamesinca]

2. I don't think the abstract says they interviwed the patient

Adults will lie about anything though, your right about that. It states that visitors had indicated a primary M.D. and/or health insurace. This may be in a follow up interview over the phone, it may be off of admission paperwork.

[liberalnurse]

3. I read thru the article

looking for the to data collection source......because I find it sooooo hard to believe based upon what I see daily in an urban community.

I think they lie to save face.

snip>

Methods This was a multivariate analysis of the 2000 to 2001 nationally representative Community Tracking Study Household Survey

and ....

snip>

adults reported

I see and speak with individuals during intake histories and they seem to always report either getting treatment from a free community clinic and the emergency room. Just the other day, I spoke with a cardiac client who only went to the ED, a hypertensive client, an epileptic client all who only got there services thru the ED when they needed a new prescription. I had another who had a lump on the back of her neck, it was just scar tissue from an old fight injury and told her so, but she said she was going to the ED to have it checked out......That is what I hear daily.

[jamesinca]

4. I am going to have to read the body of it

I have not done that yet and it should be revealing. In any case it hopefully will blow holes in the republican argument of the poor and uninsured plugging up the E.R.

[liberalnurse]

5. They do....but the availability of healthcare

insurance is scant these days. The poor are loosing resources daily and are even going into jail to get care. The republicans never look at why things are happening.

[Mark H]

6. I just had this discussion today with my sister

She is an ER nurse in Kansas City. She said that 70% of her patients are non emergency with no insurance.

[jamesinca]

7. I wonder if it depends on the shift that is worked

Are there more insured in there during the day, or at night. This study does raise a lot of questions

[Mark H]

8. I really didn't think to ask her that.

The fact remains that these people just don't get the care they need. If they need follow up care they have no options. They have to go back to the ER. She talked about a lady that broke her arm, found that no orthopedic doctor in town took the government program she had and finally just went to the ER. They had to re break her arm to fix it.