Young adults in the emergency room

Who goes to the emergency room – and why?

A new report from the U.S. Centers for Disease Control and Prevention sheds some light on emergency room use last year among a subset of folks not typically associated with needing much emergency care – young adults ages 19 to 25.

It’s a demographic worth studying for two reasons: First, these individuals are often working entry-level or temporary jobs or attending school and are vulnerable to being uninsured. And second, the report provides some idea of how young adults are faring under the Accountable Care Act, which allows them to remain covered by their parents’ health insurance until age 26.

The statistics, which were collected from January through September of last year through the National Health Interview Survey, don’t contain any big surprises. Young adults who were poor were more likely to lack a usual place for receiving health care and more likely to have visited the emergency room than those who weren’t poor. Young adults with public health coverage also were more likely to have gone to an emergency room than their counterparts who had private insurance or were uninsured.

The report confirms something else that’s echoed in other recent studies about health care utilization: The young adults who were surveyed were much more likely to delay needed care if they were uninsured. Nearly one in three who were uninsured said they had skipped seeing a doctor in the past year because of the cost. For those with public coverage, it was 10.1 percent; for the privately insured, it was 7.6 percent.

In fact, the statistics more or less mirror what’s happening with the rest of the adult population under age 65. Contrary to popular belief, most studies indicate that emergency rooms are not being unduly clogged with the uninsured. Indeed, this group seems to be the least likely to visit the ER except as a last resort – probably because they fear being saddled with a large bill they won’t be able to pay.

Regardless of age, the highest ER utilization tends to be among those on Medicaid. Various studies have pointed to a number of reasons: These folks might have more difficulty finding a primary care doctor and more difficulty making a timely appointment, forcing them to turn to ER care instead. Problems with transportation and lack of medical clinics close to where they live have also been identified as barriers.

The persistence of these patterns, even among a fairly narrow subset of young adults who belong to one of the healthiest age groups, is troubling. It suggests there are deeper issues involving socioeconomics, physician supply and demand and overall access than can be cured simply by providing more young adults with health insurance.

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