The impact of resident physician coverage on emergency department visits in South Carolina

This study examines emergency department (ED) visits to assess the potential impact on rural and minority patients if the practice of resident moonlighting was limited.

Billing data from all South Carolina ED visits in 1998 were linked to the physician licensure file. Logistic regression analysis was performed to determine patient characteristics predictive of being seen by a resident physician.

Resident physicians attended 3.4% of visits for patients residing in rural areas and 1.4% of those from urban areas. The odds of being treated by a resident were higher among persons living in health professional shortage-designated or rural areas, minorities, and persons with government insurance.

Patients from vulnerable populations have greater odds of being seen by a resident physician for an ED visit. These populations may be placed at risk for reduced access to health care services if limitations on resident physician moonlighting impair the ability of rural hospitals to staff EDs.