Characteristics of Occasional and Frequent Emergency Department Users
Do Insurance Coverage and Access to Care Matter?
Document date: February 01, 2004
Released online: February 01, 2004
This paper uses the 1997 and 1999 National Survey of America’s Families to explore how insurance coverage and access to care, along with other individual characteristics, are related to the large differences in Emergency Department (ED) use among the general population. People are classified into three ED use levels based on the number of visits over the 12 months prior to the survey: non-ED users (zero visits), occasional users (one or two visits), or frequent users (three or more visits). People in fair/poor health are 3.74 times more likely than others to be frequent ED users as compared to non-users. The uninsured and the privately insured adults have the same risk of being frequent users, but publicly insured adults are 2.08 times more likely to be frequent users. Adults who made three or more visits to doctors are 5.05 times more likely to be frequent ED users than those who made no such visits. It seems hard to blame the overcrowding of EDs on the uninsured. Instead, the publicly insured are over-represented of among ED users. Frequent ED users do not appear to use the ED as a substitute for their primary care and, in fact, are a less healthy population who need and use more care overall. (Medical Care 42(2): 176–82, February 2004.)
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