Access to emergency care: Restricted by long waiting times and cost and coverage concerns

Study objective: We monitor progress toward Healthy People 2010 objectives of reducing health disparities and decreasing delay and difficulty in access to emergency care. Methods: This was a secondary analysis of 2001 National Health Interview Survey interviews of 33,326 adults to provide population-based estimates of self-reported delay, difficulty, or inability to get care from a hospital emergency department (ED) in the preceding 12 months. Results: About 7.7% of the estimated 36.6 million adults who sought care in a hospital ED in the preceding 12 months reported a delay in receiving care, having difficulty receiving care, or being unable to receive care. Waiting times were the most-frequently noted cause of problems. Concerns about service costs and insurance coverage were also commonly cited access barriers. Access problems were more likely to be reported by adults without health insurance, younger adults, adults in fair or poor health, and adults with annual incomes of less than $20,000. Conclusion: Self-reported access to ED care is impeded by prolonged waiting times and by cost and insurance coverage concerns. These access problems are occurring more frequently among groups that face multiple social and economic disadvantages. Hospital operational changes to reduce ED treatment delays and health care financing policies that reduce insurance coverage inequities may both be needed to meet these Healthy People 2010 objectives.