Study Challenges Myths About Frequent ER Users

The widely held belief that mentally ill substance abusers are the most frequent users of hospital emergency departments is an "urban legend," a new study claims.

Researchers examined emergency room visits by more than 212,000 Medicaid patients in New York City since 2007. The analysis showed that problems associated with substance abuse and mental illness accounted for only a small share of the visits made by frequent ER users.

In addition, ER use accounts for a small portion of these patients' total Medicaid costs, found researchers John Billings from New York University and Maria Raven of the University of California, San Francisco.

They also found that frequent ER users often have multiple chronic health conditions and many hospitalizations, according to an NYU news release.

In the study published in the December issue of the journal Health Affairs, the authors wrote that "contrary to urban legend, most repeat users in the study did appear to have relatively strong linkage to ambulatory care, at least as evidenced by their high rates of primary and specialty care visits. Except for [emergency department] users with 10 or more visits in the index [initial] year, ambulatory care visit rates actually exceeded [emergency department] visit rates."

Emergency room use is not a major contributor to the cost of Medicaid, but learning more about Medicaid patients who frequently seek ER care could help policymakers determine how best to meet these patients' needs and control costs, the researchers said.

More information

The American College of Emergency Physicians outlines when you should go to the emergency room.