Trends in Nonemergent Use of Emergency Departments by Health Insurance Status

This article describes trends in nonemergent emergency department (ED) visits by insurance type, using the 2000-2009 National Hospital Ambulatory Medical Care Survey and Current Population Survey. We analyzed trends in the probability that an ED visit is nonemergent and in nonemergent ED visit rates per person. We found that visits for Medicare enrollees were least likely to be for nonemergent reasons, while uninsured visits were most likely to be nonemergent. When we accounted for total visits and population size by insurance group, we found nonemergent ED visit rates per person were largest among Medicaid enrollees. Trends in nonemergent ED visit rates were stable for all insurance groups. The findings suggest a reliance on the ED for nonemergent care by the Medicaid population. It will be important to continue to track patterns of nonemergent ED utilization after Medicaid expansions under the Affordable Care Act.