Characteristics of Medicaid-Covered Emergency Department Visits Made by Nonelderly Adults: A National Study

Abstract

Background The Affordable Care Act has added millions of new Medicaid enrollees to the health care system. These patients account for large proportion of Emergency Department (ED) utilization. Objective To characterize this population and their ED use at a national level. Methods We used the 2010 National Hospital Ambulatory Medical Care Survey (NHAMCS) to describe demographics and clinical characteristics of non-elderly adults (≥18 and ≤64 years old) with Medicaid covered ED visits. We defined frequent ED users as individuals who make ≥ 4 ED visits/year and business hours as (8AM to 5 PM). We used descriptive statistics to describe the epidemiology of Medicaid covered ED visits. Results NHAMCS contained 21,800 ED visits by non-elderly adults in 2010, of which 5,659 (24.09%) were covered by Medicaid insurance. Most ED visits covered by Medicaid were made by patients who are young (25 and 44 years old) and females (67.95%; 95% CI 66.00–69.89). A large proportion of the ED visits covered by Medicaid were revisits within 72 hours (14.66%; 95% CI 9.13–20.19), and from frequent ED users (32.32%; 95% CI 24.29–40.35). Almost half of all ED visits covered by Medicaid occurred during business hours (45.44%; 95% CI 43.45–47.43). Conclusions The vast majority of Medicaid enrollees who used the ED were females, young, with a large proportion of visits occurring during business hours. Furthermore, almost one third of all visits are from frequent ED users.