Healthcare News & Insights

Eye-opening study: Do all EDs treat uninsured kids equally?

You know that emergency departments must treat every person who walks through the doors seeking treatment. And you would think any sick or injured child would receive the same quality of treatments. But do they?

Unfortunately, the answer may be no, according to a study published in The Journal of Pediatrics.

The study makes it appear that insurance coverage may play a vital role in the care children get.

Researchers from Children’s Hospital Boston found:

  • compared to children with private insurance, those with public insurance (Medicaid or CHIP) or no insurance were 22% less likely to be tested or have a procedure when they went to the emergency room, and
  • children who didn’t have insurance were less likely to receive any medication than those with public or private insurance.

However, these findings didn’t hold true for children diagnosed with a significant illness.

The study was based on an analysis of emergency department (ED) visits recorded in the National Hospital Ambulatory Medical Care Survey from 1999-2008. It’s based on approximately 33,000 annual visits.

So what’s the reason for the treatment disparity?

The study authors gave some possible explanations for it:

First, children with private insurance are 11 times more likely than children without insurance or with public insurance to have a primary care physician (PCP). Therefore, when children with insurance go to the emergency room (ER) they are usually referred there by their PCP with instructions from the PCP for a specific workup, including extra tests and procedures.

Secondly, children with PCPs are less likely to go to the ER for non-emergency care.

Finally, parents who don’t have insurance or their children have public insurance are more worried about money and request fewer tests and treatments.

So are ERs skimping on care to uninsured and publicly insured kids because private insurance pays more so those kids get more attention?

It’s highly unlikely. The clinicians that work in the ER don’t know whether a child has private insurance, Medicaid or no insurance.

What do you think is the behind the treatment disparity in these patient populations? Share your opinions in the comments area below.


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