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Medicaid Access Increases Use of Emergency Departments by 40% — Physician’s First Watch

Medical News |
January 3, 2014

Medicaid Access Increases Use of Emergency Departments by 40%

By Joe Elia

Increased availability of Medicaid coverage is associated with higher use of emergency departments (EDs), according to a Science article.

Oregon modestly widened Medicaid access among low-income adults in 2008 through a lottery. The randomized nature of the lottery enabled researchers to compare ED use among lottery winners with use among those who applied but didn't win (controls).

During an 18-month observation period, ED visits increased by 40% among those covered by Medicaid relative to those without coverage: overall, Medicaid enrollees had an average of 1.43 ED visits, versus 1.02 among controls. Coverage increased ED use for all types of nonemergency visits, including those rated as "primary care treatable." The proportion of visits resulting in hospital admission, however, did not increase.

A commentator writes that under the Affordable Care Act, "we have good reason to anticipate a large increase — and almost surely not a decrease — in traffic to already overburdened emergency departments across the country."

Reader Comments (3)

MICHELE LAFAVE Other Healthcare Professional, Internal Medicine, hospital er

I agree wholeheartedly. Our er is trying out triaging these pts to an urgent care within the er, staffed by nurse practitioners.

Lepianka, Christine MS RN Other Healthcare Professional, Obstetrics/Gynecology, St. Anthony College of Nursing

I am curious to know if the increase in ED visits by those lottery winners who were issued a Medicaid card found it difficult to access primary healthcare or were just irresponsibly seeking healthcare.

Michael Eliastam MD Physician, Emergency Medicine, Med School Dean type

Only easy access to receptive primary care providers, not only MDs will reduce this, We need rapid expansion of Nurse Practitioners and Physician Assistants, exploitation of telemedicine, and more PRIMARY CARE residency slots ONLY.

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