A study by University of Michigan Medical School researchers suggests that the expansion of insurance under the Affordable Care Act may result in more visits to primary care clinics and fewer to emergency departments, the university health system's news service reports.

The reseachers examined patterns of ED and non-emergency outpatient visits made by patients between the ages of 11 and 18 covered by the Children's Health Insurance Program and young adults aged 19 to 29, not covered by CHIP.

The researchers found:

* Outpatient visits rose significantly among adolescents after CHIP went into effect, while young adults’ outpatient visits were flat.

* ER visits by adolescents stayed flat after CHIP went into effect, while ER visits by young adults rose.

* The ratio of outpatient-to-ER visits rose among adolescents, but fell among young adults. A ratio such as this, which shows the balance between the types of care settings, could be useful for assessing the impact of insurance reforms.

“Looking at both emergency department visits and outpatient visits together is important,” study leader Adrianne Haggins, M.D., said. “When we’re thinking about access to health care and insurance reform, insurers and hospitals can not solely focus on limiting the number of emergency visits – we have to make sure there's adequate access to alternative outpatient care.”


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