Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Programas de Assistência Gerenciada/economia , Medicaid/economia , Saúde da População , Nascimento Prematuro/prevenção & controle , Cuidado Pré-Natal/economia , Melhoria de Qualidade , Adulto , Feminino , Humanos , Mississippi , Gravidez , Estados UnidosRESUMO
BACKGROUND: National trends in Emergency Department (ED) use suggest Medicaid recipients visit the ED more frequently and make more non-emergent ED visits than those uninsured and privately insured. Given the absence of data on Medicaid beneficiaries in Mississippi, it is important to explore their ED utilization, particularly frequent and non-emergent ED visits. METHOD: Medicaid claims data were used to calculate ED visit rates and identify common diagnoses within the Mississippi Medicaid population. Non-emergent ED visits were classified using the NYU ED algorithm. RESULTS: In 2012, 605,555 ED claims were made by 290,324 Medicaid beneficiaries in Mississippi, representing 43.7% of the Medicaid population (664,583). Twelve percent of ED users were frequent users (4 or more claims per year). Most claims (57.5%) were non-emergent, meaning they could have been treated in a primary care setting. CONCLUSION: High rates of non-emergent ED visits suggest gaps in primary care delivery for Mississippi Medicaid beneficiaries.