September 1, 2004

Report highlights emergency room abuse

Men, poor families and African Americans are more likely to head to the state’s emergency rooms for routine care rather than seek out a family doctor or clinic, according to a new report from the California Institute for County Government at California State University, Sacramento. Latinos, Asian Americans and older adults, meanwhile, are among the groups less likely to do so.

Overall, the report says, a quarter million California adults and more than 60,000 children use high-cost emergency rooms for routine care, increasing overall health costs and putting a strain on hospitals and counties.

The report, “Using Hospital Emergency Rooms for Routine Care,” offers the only recent analysis of emergency room misuse in California.

It found lack of private health insurance plays a big part. Those without insurance and those insured by Medi-Cal or Medicare, are much more likely to use emergency rooms for primary care.

Emergency room care costs an estimated six times more than treatment in a physician’s office, but for various reasons this bad option for communities is often the best option for patients. The report’s authors suggest policymakers make it easier for physicians to accept Medi-Cal patients – making patients more likely to seek care outside the emergency room. They also suggest Medi-Cal patients be charged a higher co-payment for emergency room visits.

“Thousands of Californians do not have a relationship with a primary care doctor and instead use the emergency room,” says Matthew Newman, a co-author of the report. “That isn’t good for patients, and it isn’t good for state and local government finances.”

Newman says he and other researchers were surprised to find that non-citizens are less likely to use the emergency room – for primary care or true emergencies – than citizens. Less surprisingly, he says, were findings that those in relatively poor health are more likely to show up in the emergency room, as are young adults and single parents.

The report is based on a detailed statistical analysis of the 2001 California Health Interview Survey of 55,000 households in the state. Along with Newman, it was co-authored by Eric Hays, also of the California Institute for County Government, and Charles Lieberman, a research fellow with the institute.

The full report is available online at by clicking “publications.” The California Institute for County Government can be reached at (916) 324-0796.

Additional media assistance is available from the Sacramento State public affairs office at (916) 278-6156.


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