Emergency room (ER) referrals and health insurance in the United States

Soc Work Public Health. 2015;30(3):236-49. doi: 10.1080/19371918.2014.992587. Epub 2015 Mar 9.

Abstract

This article aims to determine how various health insurance policies affect the rate of emergency room (ER) referrals in the United States. The secondary data, gathered in National Health Measurement Study (NHMS) in 2008 and 2010, was used. The authors identify the relationships between health insurance and ER referrals by using zero-inflated binomial and zero-inflated Poisson regression. About 17% (2008) and 20% (2010) of the respondents had one or more ER referrals in the 2 years; those who were under coverage of governmental health insurance are more likely to refer ER than uninsured group. The differences in ER referrals that ended with hospital admission across different insurance policies are not significant. Health insurance is a remarkable factor in ER referrals; the coverage of health insurance plans can affect consuming the services provided in ER. Governmental insurance plans can increase ER referrals.

Keywords: Emergency room; Medicaid; Medicare; health insurance.

MeSH terms

  • Emergency Service, Hospital*
  • Female
  • Health Care Surveys
  • Humans
  • Insurance Coverage*
  • Insurance, Health*
  • Interviews as Topic
  • Male
  • Qualitative Research
  • Referral and Consultation / statistics & numerical data*
  • United States