ED use: up for most, but for different reasons.(In Medicine & Health Perspectives this week ...)

Publication: Medicine & Health

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Both the insured and the uninsured have been visiting hospital emergency departments more often, but for significantly different reasons.

This is the picture offered by the Center for Studying Health System Change in a recent issue brief, which suggests that ED overcrowding has broader and more complex roots than is often thought. Using data from the National Center for Health Statistics, HSC says ER visits went up about 16 percent between 1996-97 and 2000-01. Three-fourths of the increase stemmed from greater per-person ED use--from 35 annual visits per 100 people in 1996-97 to 39 visits per 100 hundred people in 2000-01--and one-fourth of the increase resulted from general population increase.

* Increased ED Use: Not Just An Uninsured Phenomenon.

"Contrary to the perception that the uninsured account for a disproportionate amount of the increase in ED use, most of the increase in visits was due to increased use by insured people, especially the privately insured," HSC says. Those insured either privately or through Medicare accounted for about two-thirds of the increase in visits over the study period, and the privately insured alone accounted for over half the total increase.

In contrast, the uninsured accounted for only about 11 percent of the increase in ED visits. The rest of the increase stemmed from people with other types of coverage, such as workers' compensation, or with unknown coverage.

This is not to say that the uninsured were not visiting the ED more often, too. In fact, this group had the...

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