Philadelphia, Pa. (July 16, 2013) After switching to high-deductible health plans (HDHPs) in the US, men make fewer emergency department visits for even severe problemswhich may lead to a later increase in hospitalization rates, suggests a study in the August issue of Medical Care, published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
In contrast, women respond to HDHPs more appropriately, reducing emergency visits only for less-severe problems. The gender differences raise concerns that "[M]en who transition to HDHPs may forego needed care in the immediate term, resulting in delays or increased severity of illness when care is later sought and received," according to the study by Katy B. Kozhimannil, PhD, MPA, of University of Minnesota School of Public Health, Minneapolis, and colleagues.
When Deductibles Rise, Men Avoid the Emergency Room
The researchers analyzed data from a large insurance plan on members whose employers had mandated a switch to an HDHP. These increasingly popular plans feature lower premiumsbut also have higher annual deductibles, which members must typically pay out of pocket. Members in the HDHPs had individual deductibles ranging from US$500 to $2,000, with family deductibles of US$1,000 to $4,000.
For the study, changes in health care use in the first two years were assessed for approximately 6,000 men and 6,500 women in the US who switched to an HDHP. Trends were compared with men and women who remained in a traditional HMO plan.
In the year after transition to an HDHP, men made significantly fewer emergency department visits. Visits for low- and intermediate-severity problems decreased by 21 percent, while high-severity visits decreased by 34 percent, compared to men who remained in HMOs.
Women also made fewer emergency visits after switching to an HDHP,
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Wolters Kluwer Health