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Universal Coverage and ED Visits

Posted by: Editor on February 9, 2010

We are now learning that universal coverage does not necessarily mean reduced ED visits. The original postulate was that if all were insured, fewer people would need to go to an ED for primary care. They would have a traditional "medical home" environment and willing physician practitioners due to the patient's "insured" status. Apparently, nothing could be further from the truth.

In October 2009, Harris Poll conducted a survey on behalf of the American College of Emergency Physicians (ACEP) in Massachusetts, a state that has universal coverage and reports that 95 percent of its residents are insured. It found that ED volume remained the same or worse yet, increased. In fact, ED physicians reported during the survey that ED "wait" times and even "boarding" stayed the same and may have increased in some facilities.

This might be shocking to some, but the fact is that there still remains insufficient primary care physicians to treat this new group of insured patients. And evidence from the various schools of medicine, it does not appear that there will be a fix to this problem anytime soon. This will remain primarily an "ED problem."

Your thoughts?

Mike Williams
President

Comments

Submitted by Guest (not verified) on Tue, 02/09/2010 - 14:24.
As long as patients have a need to be seen, and as long as primary care and specialty clinics/practices have backlogs in their schedules, patients with even minor injuries and illnesses will continue to come to Emergency Departments. In Emergency Medicine, we are tasked to care for most patients within 30 minutes of presentation. For primary care and specialists, they have no responsibility or obligation to see anyone even within a calendar year! Insured or uninsured, unless access to care primary and speciality care improves, the Emergency Departments are always going to be the quickest access to care. Increasing insurance coverage may not affect this, unless the undercapacity issue is addressed.

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