Practice Economics
Young adults are using emergency departments less following the implementation of expanded coverage under the Affordable Care Act, though the number of patients from this population has not significantly changed.
According to new research published in Health Affairs, ED visits by young adults increased by 3.8 visits/1,000 people between pre-ACA implementation (Sept. 1, 2009-Aug. 31, 2010) and post-ACA implementation (2011 calendar year), while the control group of adults ages 26-31 [years] increased by 6.5/1,000 people. "The difference-in-differences analysis estimated an absolute difference of –2.7%/1,000 people among the younger group, compared to the older group. After regression adjustment ... the difference-in-differences analysis estimated a reduction of 2.1% in young adults ages 19-25 [years], compared to people ages 26-31 [years]."
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Since the implementation of Obamacare, young adults have gone to the emergency room in smaller numbers.
Researchers analyzed data from three states – California, Florida, and New York – and also found that among people aged 26-31 years, the probability of an ED visit between pre-and post-ACA implementation increased by 2.2%, while young adults aged 19-25 years had a smaller increase of 1.9%.
Findings were published online Sept. 8 and are scheduled to appear in the September issue of Health Affairs (2014 [doi:10.1377/hthaff.2014.0103]).
"Our results suggest that the ACA’s dependent coverage provision is associated with a relative decrease in the number of ED visits for young adults but a minimum relative decrease in the rate at which they ever used the ED," reported Tina Hernandez-Boussard of the departments of surgery and biomedical informatics at Stanford (Calif.) University, and her associates.
The authors state that the research and analysis showed that "ED use by young adults ages 19-25 expanded by a modest amount after the implementation of the ACA insurance expansion but that ED use by people ages 26-31, who were not including in the ACA expansion, grew faster. Relatively slower growth in use by the younger group is consistent with the view that the ACA decreased ED use in this age group."
Dr. Hernandez-Boussard and her associates suggest that better coverage of young adults "could have facilitated better access to health care in non-ED settings such as doctors’ offices, which could have reduced the use of ED care."
