Privately Insured People’s Use of Emergency Departments

Perceived urgency, not convenience, fuels ED use by privately insured patients. That’s the finding published in a final research briefing from the Center for Studying Health System Change. Convenience was rarely mentioned as a reason for choosing to go to the ED.

Nearly half of those studied with urgent medical needs first tried contacting their physician for assistance or advice, and in most cases, were treated in an office setting or the issue was managed over the phone. Another 20% of those with urgent care needs went directly to the ED or called 911. Urgent care centers were contacted or visited by 17% of the group studied.

Some other findings of note:

• Same day appointments and 24/7 nurse advice lines may be helpful in lowering ED use.
• Relying only on financial incentives may be ineffective in changing a patient’s sense of urgency.
• Some patients think ED’s offer higher-quality care than they can get from their clinicians.
• People seeking urgent care were more likely to suffer from chronic conditions. For the non-elderly insured, chronic back or neck problems, arthritis, and chronic major joint pain were the most frequent conditions cited.

Note: The Center for Studying Health System Change ceased operation on Dec. 31, 2013, after 20 years in business. It has been merged into Mathematica Policy Research.

Source: Carrier E and Boukus ER. Privately insured people’s use of emergency departments: perception of urgency is reality for patients. Center for Studying Health System Change Research Briefing, no. 31, Dec. 2013. http://www.hschange.org/CONTENT/1399/1399.pdf

Related resource: Hefner JL and others. Primary care access barriers as reported by nonurgent emergency department users; implications for the US primary care infrastructure. American Journal of Medical Quality, online first, feb. 5, 2014 at http://ajm.sagepub.com/content/early/2014/02/03/1062860614521278.abstract.html?papetoc

Posted by AHA Resource Center (312) 422-2050, rc@aha.org