Medicaid increases emergency-department use: evidence from Oregon's Health Insurance Experiment.
Publication Title
Science
Document Type
Article
Publication Date
1-17-2014
Keywords
oregon; core; diversity; Adult; Ambulatory Care; Emergency Service, Hospital; Female; Humans; Inpatients; Insurance, Health; Male; Medicaid; Medically Uninsured; Oregon; Poverty; United States
Abstract
In 2008, Oregon initiated a limited expansion of a Medicaid program for uninsured, low-income adults, drawing names from a waiting list by lottery. This lottery created a rare opportunity to study the effects of Medicaid coverage by using a randomized controlled design. By using the randomization provided by the lottery and emergency-department records from Portland-area hospitals, we studied the emergency department use of about 25,000 lottery participants over about 18 months after the lottery. We found that Medicaid coverage significantly increases overall emergency use by 0.41 visits per person, or 40% relative to an average of 1.02 visits per person in the control group. We found increases in emergency-department visits across a broad range of types of visits, conditions, and subgroups, including increases in visits for conditions that may be most readily treatable in primary care settings.
Specialty/Research Institute
Population Health
Specialty/Research Institute
Center for Outcomes Research and Education (CORE)
DOI
10.1126/science.1246183
