The impact of insurance and a usual source of care on emergency department use in the United States

Winston Liaw; Stephen Petterson; David L Rabin; Andrew Bazemore

doi:10.1155/2014/842847

The impact of insurance and a usual source of care on emergency department use in the United States

Int J Family Med. 2014:2014:842847. doi: 10.1155/2014/842847. Epub 2014 Feb 9.

Authors

Winston Liaw¹, Stephen Petterson², David L Rabin³, Andrew Bazemore²

Affiliations

¹ Department of Family Medicine, Virginia Commonwealth University, 3650 Joseph Siewick Drive, No. 400 Fairfax, Richmond, VA 22033, USA.
² The Robert Graham Center, 1133 Connecticut Avenue, NW Suite 1100, Washington, DC 20036, USA.
³ Department of Family Medicine, Georgetown University, 4000 Reservoir Road, NW, Washington, DC 20007, USA.

Abstract

Background. Finding a usual source of care (USC) is difficult for certain populations. This analysis determines how insurance type and having a USC affect the settings in which patients seek care. Methods. In this cross-sectional study of the 2000-2011 Medical Expenditure Panel Surveys, we assessed the percentage of low-income persons with half or more of their ambulatory visits to the emergency department (ED). Respondents were stratified based on insurance type and presence of a USC. Results. In 2011, among Medicaid enrollees without USCs, 21.6% had half or more of their ambulatory visits to EDs compared to 8.1% for those with USCs. Among the uninsured without USCs, 24.1% went to an ED for half or more of their ambulatory visits compared to 8.8% for those with USCs in 2011. Among the privately insured without USCs, 7.8% went to an ED for half or more of their ambulatory visits compared to 5.0% for those with USCs in 2011. These differences remained in multivariate analyses. Conclusions. Those who lack USCs, particularly the uninsured and Medicaid enrollees, are more likely to rely on EDs.