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What's Your Emergency?

Health care reform may account for a drop in low-severity emergency department visits

While overall emergency department (ED) use in Massachusetts continues to rise, the number of low–severity visits dropped slightly since implementation of the state’s mandatory health care coverage law, according to an Annals of Emergency Medicine study published online in June.

“Our study suggests other factors play a role in determining access to care and use of the ED in addition to one’s insurance status,” wrote Peter Smulowitz, the study’s lead author and an HMS instructor in medicine at Beth Israel Deaconess Medical Center. “These likely include availability of primary care, convenience of ED hours, and the ability to obtain a comprehensive evaluation and testing at one time in the ED.” Smulowitz added that it may take patients time and effort to alter their care–seeking patterns.

The small decrease in low–severity visits was contrary to expectations before the implementation of reform, Smulowitz wrote. “To the extent that policymakers expected a substantial decrease in overall and low–severity ED visits, this study does not support those expectations.”

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