High-cost sharing policies and non-urgent emergency department visits

International Journal of Health Care Quality Assurance,Volume 31, Issue 7, Page 735-745, August 2018. Purpose The purpose of this paper is to examine whether high-cost-sharing ambulatory care policies affect non-urgent emergency department (ED) care utilization differently among individuals with and without chronic conditions. Design/methodology/approach This retrospective cohort study used 2010 –2011 US Medical Expenditure Panel Survey data. Difference-in-difference methods, multivariate logit model and survey procedures were employed. Time lag effect was used to address endogeneity concerns. Findings The sample included 4,347 individuals. Difference in non-urgent ED visits log odds be tween high- and low-cost-sharing policies was not significantly different between chronically ill and non-chronically ill individuals (β=−0.48, p=0.42). Sensitivity analysis with 15 and 25 percent cost-sharing levels also generated consistent insignificant results (p=0.33 and p=0.31, respectively ). Ambulatory care incidence rates were not significantly different between high- and low-cost-sharing groups among chronically ill people (incidence rate ratio=0.849, p=0.069). Practical implications High-cost-sharing ambulatory care policies were not associated with increased non-urgent ED care utilization among chronically ill and healthy people. The chronically ill patients may have retained sizable ambulatory care that was necessary to maintain their health. Health plans or employers may...
Source: International Journal of Health Care Quality Assurance - Category: Health Management Source Type: research