DOES INSURANCE MATTER FOR HOSPITAL ADMISSION?

As part of the Society for Academic Emergency Medicine’s initiative to evaluate disparities in health care, we studied the relationship between insurance status and admission to the hospital. Due to the US government’s Emergency Medical Treatment and Labor Act (EMTALA), emergency departments are required to evaluate all patients who present to their doors, to determine if an emergency medical condition exists, and if so, to treat and stabilize it, regardless of the patient’s ability to pay. However, admission to the hospital is not mandated, and differences may exist in the admission rates of patients with similar medical diagnoses and acuity of illness, based on their insurance status. Our study, unlike prior studies, defined underinsurance as a unique financial category. Our research found that underinsured patients were less likely to be admitted to a general hospital service, particularly underinsured women with menstrual disorders and those with digestive disorders, but not to the intensive care unit and operating room.