Emergency room misuse by medical assistance patients in a family practice residency

Four hundred individual Emergency Room records were retrospectively reviewed. Demographic data, complaint, diagnosis, and treatment were tabulated and analyzed by computer assistance. Judgment was not made regarding the necessity of physician consultation, but whether an Emergency Room visit was warranted considering the duration of the presenting complaint. During a time period when 29 percent of the total outpatient visits to the Family Practice Center Model Office were made by recipients of Medical Assistance, the same population accounted for 53 percent of the Emergency Room visits reviewed. Twenty-five percent of the 400 visits were judged to be unnecessary according to the pre-established criteria. Sixty-four percent of the unnecessary visits were by Medical Assistance patients. Of 304 total families represented, 73 were responsible for multiple visits. Thirty-one percent of these visits were unnecessary, whereas 21 percent of the visits made by families with single visits were unnecessary. In this family practice setting, it is concluded that Medical Assistance patients have a greater tendency toward inappropriate use of the Emergency Room when compared to non-Assistance patients.