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Insured use emergency room more often for primary care issues than uninsured

The Star Ledger reports that “uninsured patients are less likely to visit the emergency department for non-urgent care than insured patients.”  The conclusion is based on an article in this month’s edition of JAMA written by Newton, Keirns, Cunningham, Hayward, and Stanley (2008).  

The authors examined 127 articles which studied adult medical and surgical care of uninsured patients in emergency settings.  They conclude the following:

Available data support the statement that care in the ED is more expensive than office-based care when appropriate, but this is true for all ED users, insured and uninsured. Available data do not support assumptions that uninsured patients are a primary cause of ED overcrowding, present with less acute conditions than insured patients, or seek ED care primarily for convenience.

Generally, uninsured patients only visit the emergency room if there is an emergency.  Why?  The emergency room is expensive and uninsured individuals cannot afford to use the emergency department for simple primary care issues.  On the other hand, working individuals with insurance use the emergency room because physician hours are usually during their working day and sometimes the only place to get after-hours care is the emergency room.


  1. I would like to see the data comparing ED use by Medicaid patients vs insured patients.

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