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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

llow such young adults to enroll in CHIP, making them a good comparison group in the pre-ACA era.

The researchers found:

  • Outpatient visits rose significantly among adolescents after CHIP went into effect, while young adults' outpatient visits were flat.

  • ER visits by adolescents stayed flat after CHIP went into effect, while ER visits by young adults rose.

  • The ratio of outpatient-to-ER visits rose among adolescents, but fell among young adults. A ratio such as this, which shows the balance between the types of care settings, could be useful for assessing the impact of insurance reforms.

"Looking at both emergency department visits and outpatient visits together is important," says Haggins, a clinical lecturer in the U-M Department of Emergency Medicine. "When we're thinking about access to health care and insurance reform, insurers and hospitals can not solely focus on limiting the number of emergency visits we have to make sure there's adequate access to alternative outpatient care."

The new results, she says, suggest that CHIP did just that, making it easier for pre-teens and teens to get outpatient care while still keeping emergency care available. The study did not look at the appropriateness of the emergency visits.

Haggins also notes that the findings emphasize the importance of ensuring adequate outpatient capacity in the months and years after an insurance expansion. "If a newly insured patient has a hard time finding a provider who would accept their insurance, or getting appointments with the ones who will, there is a real possibility that we will continue to see them go to the emergency department."

More understanding is needed about the factors that prompt patients to choose emergency care rather than outpatient appointments such as convenience, expectations for care, demand for diagnostic tests, and habit, she says.

Confronting the force of habit may be a bi
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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