Use of Emergency department (ED) has been affected by insurance patterns over time and will likely be further affected by expansions of coverage from health care reform. Uninsured patients are often thought of as high and frequently inappropriate ED users, but insured patients, particularly those with Medicaid coverage, may have difficulties accessing primary care and may rely on EDs more frequently than uninsured patients, write Renee Y. Hsia, M.D., M.Sc., of the University of California, San Francisco, and colleagues. In a Research Letter appearing in the September 18 issue of JAMA, the authors investigated recent trends in the association between insurance coverage and ED use. The study was a retrospective analysis of California ED visits by adults 19 to 64 years of age from 2005-2010 that used the nonpublic versions of data from the California Office of Statewide Health Planning and Development''s Emergency Discharge Data and Patient Discharge Data. To study variations by insurance coverage, ED visits were grouped into 4 categories based on expected source of payment: Medicaid, private insurance, self-pay or uninsured, and other. The authors also looked at ED visits for ambulatory care sensitive conditions (ACSCs) The researchers found that between 2005 and 2010, the number of visits to California EDs by adults overall increased by 13.2 percent from 5.4 to 6.1 million per year. The largest increase in visits occurred in 2009. The share of total visits increased among adults with Medicaid coverage and uninsured adults, whereas the share decreased among adults with private insurance. Visit rates to the ED among adult Medicaid beneficiaries were higher than uninsured and privately insured patients. "Increasing ED use by Medicaid beneficiaries could reflect decreasing access to primary care, which is supported by our findings of high and increasing rates of ED use for ambulatory care sensitive conditions by Medicaid patients. The increase in ED visits was highest in 2009, likely due to the H1N1 pandemic and the influence of the economic downturn on coverage transitions and access to care," the authors write.(doi:10.l001/ jama.2013.228331; Available pre-embargo to the media at http://media.jamanetwork.com)Source: Newswise << Brain is Hard-Wired for Chronic Pain: Study France may Ban Beauty Contests for Girls Under 16 >> Recommended Reading In Emergency Departments, Electronic Tool Helps Reduce Deaths from Pneumonia: Study A new study has found that an electronic decision support tool helped to reduce deaths from pneumonia in four hospital emergency departments. READ MORE Study Analyses The Aging Population and Emergency Departments One might assume that the number of trips to the emergency department will also increase as the population gets older, and the baby boomers begin to enter their 60's and 70's. READ MORE Patient Factors Play an Important Role in Emergency Department Imaging A new study explains how despite concerns to the contrary, very little of the variation in Emergency Department (ED) imaging utilization is attributable to physician gender, training or experience READ MORE Efforts to Reduce Preventable Emergency Department Use In an analysis that included a sample of patients in the top portion of Medicare spending, only a small percentage of their costs appeared to be related to preventable emergency department visits and hospitalizations. READ MORE Road Traffic Accidents and Road Safety Road accidents are one of the significant causes of disability, injury and death in the world. Every hour, nearly 14 lives are lost due to road accidents in India. READ MORE What is Medicare / Medicaid? Medicaid / Medicare are different governmental programs that provide medical and health-related services to specific groups of people in U.S. and managed by Centers for Medicare and Medicaid Services. READ MORE Women More Prone to Road Rage If you find your self getting mad and cursing under your breath while driving, you are a victim of road rage. READ MORE Most Popular on Medindia A-Z Drug Brands in India The Essence of Yoga Fongitar (Zinc Pyrithionone) More News on: EmergencyAlarming Facts about Road Traffic AccidentsRoad Traffic Accidents and Road SafetyWomen More Prone to Road RageWhat is Medicare / Medicaid?