Difference in Access to Post-ER Followup Care

Excerpted from Reuters, describing an article in JAMA:

NEW YORK (Reuters Health) - After being treated in a emergency room for an urgent condition, Americans with private health insurance are much more likely to secure a timely follow-up appointment with a community doctor than those with Medicaid or no health insurance, a study shows.

"The bottom line is that if you're not a card carrying member of our healthcare system you're going to have a very difficult time getting access to care, " Dr. Brent R. Asplin from Regions Hospital and HealthPartners Research Foundation in St. Paul, Minnesota, told Reuters Health.

Americans will make roughly 114 million visits to hospital ERs this year alone, and more than 80 percent will be treated and discharged with a recommendation to seek follow-up care. That, however, may be easier said than done, according to Asplin and colleagues who examined access to follow-up appointments according to insurance status in nine US cities.

As they report in the Journal of the American Medical Association this week, eight research assistants called 499 ambulatory clinics and identified themselves as in need of follow-up care for pneumonia, high blood pressure or possible ectopic pregnancy -- early pregnancy implanted outside the uterus, such as in the Fallopian tube.

The same research assistant called each clinic twice using the same scenario but reporting different insurance status - no insurance, private insurance, or Medicaid -- the federal/state program for the poor.

"In our study, the callers who were trying to get appointments had potentially very serious conditions," Asplin emphasized. "These were not people trying to get an appointment for a sore throat or a cold. But despite the severity of there conditions, callers still had problems getting appointments when they didn't have the right insurance card."