Gandhi Sabina Ohri, Grant Lauren P, Sabik Lindsay M
RTI International, Washington, DC, USA
Virginia Commonwealth University, Richmond, VA, USA.
Med Care Res Rev. 2014 Oct;71(5):496-521. doi: 10.1177/1077558714541481. Epub 2014 Jul 7.
This article describes trends in nonemergent emergency department (ED) visits by insurance type, using the 2000-2009 National Hospital Ambulatory Medical Care Survey and Current Population Survey. We analyzed trends in the probability that an ED visit is nonemergent and in nonemergent ED visit rates per person. We found that visits for Medicare enrollees were least likely to be for nonemergent reasons, while uninsured visits were most likely to be nonemergent. When we accounted for total visits and population size by insurance group, we found nonemergent ED visit rates per person were largest among Medicaid enrollees. Trends in nonemergent ED visit rates were stable for all insurance groups. The findings suggest a reliance on the ED for nonemergent care by the Medicaid population. It will be important to continue to track patterns of nonemergent ED utilization after Medicaid expansions under the Affordable Care Act.
本文利用2000 - 2009年全国医院门诊医疗调查和当前人口调查，按保险类型描述了非急诊急诊科就诊趋势。我们分析了急诊就诊为非急诊的概率趋势以及每人的非急诊急诊科就诊率趋势。我们发现，医疗保险参保者的就诊最不可能是非急诊原因，而未参保者的就诊最有可能是非急诊。当我们考虑各保险组的就诊总数和人口规模时，发现医疗补助计划参保者的每人非急诊急诊科就诊率最高。所有保险组的非急诊急诊科就诊率趋势都很稳定。研究结果表明，医疗补助计划人群在非急诊医疗方面依赖急诊科。在《平价医疗法案》下医疗补助计划扩大后，继续跟踪非急诊急诊科利用模式将很重要。
