Effects of Insurance Status on Emergency Room Care and Outcomes

Health economics researchers have long known insurance status has an impact on the use of health care system (Hadley 2003); however, measuring the causal effect of insurance status on treatment decisions and outcomes has been a difficult problem for economists to tackle. This paper builds upon earlier work by Doyle (2005) in examining the effects of insurance status on injury patients in the emergency room. Doyle (2005) uses a Wisconsin sample of patients reporting with injuries resulting from motor vehicle accidents. The present examination improves on Doyle’s study by broadening the dataset, controlling for overall health status and considering multiple types of health shocks. I use a nationwide dataset of emergency department visits to compare the differences between the effects of insurance status on treatment for patients with injuries from motor vehicle accidents and patients with other types of injuries while controlling for overall health status. This paper reaches three primary conclusions: (1) Patients paying out of pocket experience worse health outcomes; (2) Patients paying out of pocket receive fewer health services in response to motor vehicle accident injuries and other types of injuries; and, (3) Despite no observed differences between patients paying out of pocket and patients receiving charity care, patients generally received more healthcare services and had better health outcomes than patients with private insurance.