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Are the Uninsured Responsible for the Increase in Emergency Department Visits in the United States?
Published: April 2008
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Using data from the Community Tracking Study (CTS) Household Surveys, the authors analyzed emergency department (ED) visits in the United States to learn whether the rise in ED use could be attributed to uninsured individuals.
CTS data were collected, via telephone surveys, in four cycles: 1996 to 1997, 1998 to 1999, 2000 to 2001, and 2003 to 2004. Participants in the study were ages 18 and older and represented 60 randomly selected communities throughout the United States. Each study participant was asked about their ED visits in the previous year.
Key Findings:
- Proportion of adult ED visits by people “without” health insurance was stable across the time periods examined at approximately 15 percent of all visits
- Proportion of ED visits by non-poor patients (defined as those with family income greater than 400 percent of the federal poverty level) grew from 21.9 percent to 29.0 percent
- Proportion of ED visits by people who regularly receive care from a physician's office increased from 52.4 percent in 1996 to 1997 to 59.0 percent in 2003 to 2004, while the proportion of ED visits by those without a usual source of care were stable over the same period at just under 10 percent of visits.
The authors conclude that the documented rise in ED visits between 1996 and 2004 cannot be primarily attributed to the uninsured. Instead, major contributors to the rise in number of visits are increased visits by non-poor people and people with other regular sources of care.
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