July 31, 2009

ER Visits Mostly by Medicare, Medicaid Recipients

FRIDAY, July 31 (HealthDay News) -- An estimated 50 million, or 42 percent, of the 120 million visits made in 2006 to U.S. hospital emergency departments were billed to the Medicaid and Medicare programs, according to a U.S. government report released Thursday.

Uninsured patients accounted for nearly 18 percent of emergency department visits nationally, 34 percent were billed to private insurance, and 6 percent were billed to worker's compensation, military health plan administrator Tricare, and other payers, according to the latest News and Numbers from the U.S. Agency for Healthcare Research and Quality.

Among the other findings:

Of the 24.2 million emergency department visits billed to Medicare, 38.3 percent ended with the patients being admitted, compared with 11.2 percent of the 41.5 million visits billed to private insurers, 9.5 percent of the 26 million visits billed to Medicaid, and 6.8 percent of the 21.2 million visits by the uninsured.
Uninsured patients were the most frequent users of hospital emergency departments. Their rate of 452 visits per 1,000 people was 1.2 times greater than the rate of 367 per 1,000 people among patients with public or private insurance.
The "treat-and-release" rate for uninsured patients was 421 visits per 1,000 people, compared with 301 visits per 1,000 for those with insurance. This is a possible indication that people without insurance use hospital emergency departments as their usual source of care.

The study is based on an analysis of data from the 2006 Nationwide Emergency Department Sample, which contains records of emergency department visits from about 1,000 community hospitals nationwide. The hospitals account for 20 percent of all U.S. hospital emergency departments.

More information

The American College of Emergency Physicians explains when patients should go to the emergency department.

-- Robert Preidt
SOURCE: U.S. Agency for Healthcare Research and Quality, news release, July 30, 2009
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