Insured versus uninsured patients in the emergency room: is there a difference?

To define the differences in emergency room usage patterns between patients with and without medical insurance coverage.

A retrospective analysis of the database of 34 642 consecutive patient visits to an urban hospital emergency room over a period of 509 days. Arrival times and admission rates were compared for insured and uninsured patients.

A total of 46.8% of insured patients arrived at night or during the weekend versus 51.7% of the uninsured. Slightly more insured patients were admitted (18.6 versus 15.4%), both after their visit during the daytime (20.6 versus 17.1%) and outside daytime hours (16.3 versus 13.8%). The uninsured population was younger.

Uninsured patients arrived more frequently during weekends and at night than insured patients. They were on average less likely to be admitted to the hospital. Demographic differences between both groups seemed to play an important role in the admission rate. Despite differences in emergency room usage patterns, it cannot be concluded that either group used the emergency room in excess of the other.