WVU research study says emergency rooms still first choice, even for insured patients

WVCTSI members share findings at annual conference

MORGANTOWN, W.Va. – Many West Virginians are still opting to seek medical treatment at their local emergency room, regardless of being insured.

A research team from the West Virginia University School of Public Health Department of Health Policy, Management, and Leadership traveled to San Diego earlier this month to present at the Annual Research Meeting of the Academy of Health.  

The annual meeting is the premier forum for health services research, where more than 2,400 attendees gather to discuss health policy implications, sharpen research methods, and network with colleagues from around the world.

The team, led by Thomas Bias, Ph.D., assistant professor in the School of Public Health, included Parul Agarwal, M.P.H., current graduate student in the WVU School of Pharmacy; Emily Vasile, M.P.A., program coordinator for the WVU Health Research Center; Stephen Davis, M.P.A., director of clinical research for the WVU School of Medicine Department of Emergency Medicine; and Danielle Davidov, Ph.D., assistant professor in the WVU Department of Emergency Medicine, all of whom are also members of the West Virginia Clinical and Translational Science Institute.

The team’s research topic, “Emergency Department Utilization Among the Insured in West Virginia,” aimed to find the impact of the expansion of health insurance coverage through Medicaid and other qualified health plans offered through health insurance.  

The team suspected that the availability of public insurance among low-income adults may result in increased healthcare services utilization, specifically in emergency departments.

A self-administered paper-based survey to both insured and uninsured individuals showed that the team’s suspicions were not that far off. Approximately 69.5 percent of insured individuals reported visiting their local emergency department simply because they felt that their medical needs could not have been accurately treated anywhere else. This reasoning also rang true for the uninsured, with 48 percent of responses agreeing with the statement.

Other reasons behind a trip to the emergency department rather than a physician’s office or clinic included having either no place to go or their preferred provider did not offer after-hours or weekend care.

The implications of the study show that more educational outreach and resources need to be provided for those who are newly insured, since they may lack health literacy.

“These new methods of receiving health insurance were originally thought of as a solution for emergency department over-usage,” Dr. Bias said. “However, from our findings, we see that even the newly insured are continuing to use it just as often as before.”

The presented research comes from the evaluation initiative of the recently established Health Insurance Marketplace in West Virginia. The initiative is a five-year evaluation of the health, economic, and consumer marketing outcomes of the Health Insurance Marketplace throughout the state. This project is a partnership between the Health Research Center and the Health Policy Division of the West Virginia Offices of the Insurance Commissioner.

Bias and his team hope to administer the same survey later this year, as the Affordable Care Act reaches more within the rural Appalachian community.

“We hope that as more become insured through this act, stronger health policy literacy will develop among the community,” he said.

To learn more about the evaluation of the Health Insurance Marketplace in West Virginia, visit: http://publichealth.hsc.wvu.edu/hrc/Research/Current-Research/Evaluation-of-the-WV-Health-Benefit-Exchange.