Low-income patients flood rural EDs

Although rural areas typically suffer from limited access to emergency care, the emergency departments (ED) that are available experience a lot of activity, with most of it from low-income patients. In fact, of the 8 million visits made to rural hospital EDs in 2008, 6 in 10 visits were from poor patients, according to data from the Agency for Healthcare Research and Quality (AHRQ).

The data also offers some clarity on why patients came to the ED, what treatment they received, and insurance status.

The top reason for rural ED visits is abdominal pain (233,064), followed by back pain (223,248) and chest pain from unknown causes (220,647). Open wounds, at 211,587 visits, and both chronic obstructive pulmonary disease and bronchiectasis at 159,002 visits round out the top five reasons low-income adults seek emergency care.

According to the AHRQ, about 44 percent of the adult visits to rural EDs were either covered by Medicaid or were uncompensated or billed to uninsured patients.

Such findings could validate the common belief that low-income patients are a major force in ED overcrowding, as they tend to overuse emergency rooms for non-urgent conditions that could be treated in primary care settings. The AHRQ data shows that diverting non-urgent, low-income patients could help rural hospitals cut ER costs, as well as increase access to care.

For more:
- read the AHRQ findings

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