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For the Record: Being Back in E.R. May Not Mean No Insurance

For the Record: Being Back in E.R. May Not Mean No Insurance


By ERIC NAGOURNEY
Published: April 4, 2006
People who frequent emergency rooms are widely assumed to be there because they lack insurance, the implication being that their complaints are too minor to take up the E.R.'s valuable time.

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Stuart Goldenberg
A new study argues that this is largely a myth. In Annals of Emergency Medicine, researchers say they have found that most patients who make frequent emergency room visits are insured and have a regular source of health care.

But the researchers argue that, given the variety of serious illnesses that these generally low-income patients often suffer, it is not inappropriate for them to seek emergency room treatment.

"In many cases, the emergency department is exactly the right place for them to be," said one of the authors, Dr. Ellen J. Weber of the University of California, San Francisco.

The researchers, led by Kelly A. Hunt of the Robert Wood Johnson Foundation, based their findings on a national survey that asked almost 60,000 adults about their emergency room use. The researchers defined a frequent patient as one who made four or more visits a year.

The issues of who goes to the emergency room and why have grown in importance as pressures on E.R. doctors have increased. From 1993 to 2003, the study said, emergency room visits went up about a quarter. In 2003, most emergency departments said they were at or over capacity at least half the time, the researchers said.

The study found that 84 percent of the frequent users had insurance and that 81 percent had regular health providers.

Although the study found that frequent emergency room visitors often had good reason to be there, it suggested that that there were better ways to take care of their needs.

"Clearly, having the patient be able to go to a primary care physician who knows them — that's the best kind of care," Dr. Weber said.


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