Health insurance, neighborhood income, and emergency department usage by Utah children 1996-1998.
BMC Health Serv Res
; 5(1): 29, 2005 Apr 13.
Article
en En
| MEDLINE
| ID: mdl-15829013
ABSTRACT
BACKGROUND:
It is estimated that approximately half of emergency department (ED) usage in the U.S. and other developed countries is for non-urgent conditions and that this usage is related to availability, social, and economic factors. We examined pediatric ED usage in a U.S. state with respect to income, health insurance status, types of medical conditions, and whether introduction of managed care affected utilization by Medicaid children.METHODS:
Emergency department usage rates were calculated from 1996 through 1998 using Utah ED data for children with commercial health insurance, Medicaid, for uninsured children, and by income group estimating neighborhood household income from Zip code of residence. We analyzed usage following the July 1996 transition of Utah Medicaid to managed care.RESULTS:
Children with Medicaid had approximately 50% greater ED utilization rates than children with commercial health insurance or uninsured children. The majority of usage for Medicaid and uninsured children was for non-traumatic conditions. Only 35% of total ED usage was for non-emergent or non-urgent conditions and this was related to both Medicaid and low household income. Children lacking health insurance were more likely to be discharged against medical advice (OR = 2.36, 95% C.I. 1.88-2.96). There was no reduction in Medicaid ED usage following the transition to managed care.CONCLUSION:
Usage of ED services is related to both health insurance status and income. Children lacking health insurance and Medicaid children have excessive usage for conditions which could be treated in a primary care setting. That managed care does not reduce Medicaid ED usage is consistent with findings of other studies.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Programas Controlados de Atención en Salud
/
Medicaid
/
Servicio de Urgencia en Hospital
/
Mal Uso de los Servicios de Salud
Aspecto:
Equity_inequality
Límite:
Adolescent
/
Child
/
Child, preschool
/
Humans
/
Infant
/
Newborn
País/Región como asunto:
America do norte
Idioma:
En
Revista:
BMC Health Serv Res
Asunto de la revista:
PESQUISA EM SERVICOS DE SAUDE
Año:
2005
Tipo del documento:
Article
País de afiliación:
Estados Unidos