Do People with Health Insurance Coverage Who Live in Areas with High Uninsurance Rates Pay More for Emergency...

Area of Science:

• Health Economics
• Public Health Policy
• Healthcare Management

Background:

• Rising healthcare expenditures and varying insurance coverage rates present challenges to healthcare systems.
• Understanding the financial implications of uninsurance on healthcare services is crucial for policy development.

Purpose of the Study:

• To examine the association between the percentage of uninsured individuals in a county and the cost of typical emergency department (ED) visits.
• To determine if higher uninsurance rates correlate with increased ED expenditures.

Main Methods:

• Utilized a nationally representative sample of ED visits from 2009-2013.
• Linked data from Medical Expenditure Panel Survey with American Community Survey, Healthcare Cost and Utilization Project, and Area Health Resources Files.
• Employed a diagnosis-level fixed-effects model with controls for visit, individual, and county characteristics.

Main Results:

• A 1% increase in a county's uninsurance rate was associated with a $20 rise in the mean ED payment for privately insured patients.
• No significant association was found between uninsurance rates and ED payments for visits covered by other insurance types.

Conclusions:

• Findings suggest that increased uninsurance rates may lead to higher ED costs for those with private insurance, indicating a potential cost spillover.
• Further research using longitudinal data is recommended to establish causality and explore the impact of insurance expansions.