Senior author Dr. Adit Ginde of the University of Colorado School of Medicine in Aurora, Colo., and colleagues analyzed 230,238 adult responses to the 1999-2009 National Health Interview Survey for an association between barriers to primary care and use of the emergency department.
Overall, 16.3 percent of Medicaid beneficiaries had one or more barriers to primary care, compared to 8.9 percent of people with private insurance.
Almost 40 percent of Medicaid patients visited the a U.S. hospital emergency room within the last year versus 17.7 percent of privately insured patients, the survey said.
"Even those Medicaid patients who have primary care physicians -- and that is less likely than for people with private insurance -- report significant barriers to seeing their doctor," Ginde said in a statement. "Medicaid patients tend to visit the ER more, partly because they tend to be in poorer health overall. But they also visit the ER more because they can't see their primary care provider in a timely fashion or at all."
Even comparing patients with barriers to primary care side by side, Medicaid beneficiaries were still more likely to visit the emergency department than those with private insurance. Barriers included not being able to reach a doctor by phone, not being able to get a timely appointment or a lack of transportation to the doctor.
The findings were published in the Annals of Emergency Medicine.