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Will health insurance expansion cut ER use? U-M study in teens & young adults may help predict
Date:10/19/2013

ANN ARBOR, Mich. As the nation's health care system prepares for uninsured Americans to gain health insurance coverage under the Affordable Care Act, a question hangs over crowded hospital emergency departments: Will the newly insured make fewer ER visits than they do today?

According to the results of a new University of Michigan Medical School study in teens and young adults, the answer likely reflects a balance of ER care versus clinic visits. While the number of ER visits will likely stay about the same, clinic visits will likely go up.

The results, from the first national study of its kind, are published in Academic Emergency Medicine by a team led by U-M emergency physician Adrianne Haggins, M.D., M.S. The work was funded by the Robert Wood Johnson Foundation Clinical Scholars Program at U-M, and used data from the National Center for Health Statistics at the Centers for Disease Control and Prevention.

The researchers looked at patterns of emergency and non-emergency outpatient visits made by adolescents between the ages of 11 and 18 in the years before and after a major expansion of public health insurance coverage for this group. They were especially interested in ER care, given that it is unclear how the demand for both types of ambulatory care will change nationally when insurance is provided.

The results show the impact of CHIP, or Children's Health Insurance Program, a federal/state program signed into law in 1997 that made it possible for near-poor children to receive state-sponsored insurance. More than 7 million children now have CHIP insurance, and it remains an option under the Affordable Care Act.

By comparing the national trends in adolescents' ER and outpatient visit numbers with those for young adults (ages 19-29) in the 1992-1996 pre-CHIP era, versus post-CHIP years 1999-2009, the team could gauge the impact of CHIP as a national source of new insurance coverage. Most states didn't a
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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