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Cited by 180Emergency and Acute Care StudiesHealthcare Policy and ManagementPrimary Care and Health Outcomes

Access of Medicaid Recipients to Outpatient Care

Open access
The Medicaid Access Study Group·1994·New England Journal of Medicine
DOI 10.1056/nejm199405193302007
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Abstract

Background Visits to the emergency department by Medicaid recipients for nonemergency problems are common and contribute to rising health care costs. However, such patients may have few alternatives. We conducted a telephone survey of 953 ambulatory care sites in 10 cities to determine the availability of appointments for Medicaid recipients with common problems. Methods Research assistants telephoned all ambulatory care clinics and a stratified sample of private primary care practices in the catchment area served by the hospital emergency department in each city. The assistants identified themselves as Medicaid recipients seeking care for one of three problems (low back pain, dysuria, or sore throat) and asked a standardized series of questions. Data were collected on appointments or walk-in visits authorized at any time, within two days after the call, or after 5 p.m.; copayment requirements; and reasons appointments could not be made. If an appointment was made, it was canceled at the end of each call or shortly thereafter. Several weeks later, private-practice sites in six of the cities were recontacted; the research assistants identified themselves as patients with private insurance and the same problem. Results An appointment or an authorization for a walk-in visit was obtained from 418 of the 953 practice sites (44 percent); 47 of the sites (5 percent) could not be contacted. Appointment rates for the different types of sites ranged from 72 percent for free-standing ur…

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Crossref · 10.1056/nejm199405193302007

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  • Without correcting provider acceptance of public insurance, disparities in access between public and private insurance are unlikely to be fully eliminated, even if all other barriers to access could be addressed.

    “Without correcting this dimension, it is unlikely that disparities in access between public and private insurance can be fully eliminated, even if all other barriers to access (e.g., out-of-pocket costs, referral requirement, and need for language proficiency, transportation, and health literacy) could be addressed.15,16”

    From Auditing Access to Specialty Care for Children with Public Insurance (2011) · cites this paper as [15]

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Authors
The Medicaid Access Study Group
Corresponding author
The Medicaid Access Study Group
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1994-05-19
Volume
330
Issue
20
Pages
1426-1430
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199405193302007
OpenAlex
W4234955512
Cited by
180
References
0
Citations by year
2025: 4 · 2024: 3 · 2023: 3 · 2021: 5 · 2020: 2 · 2019: 4 · 2018: 5 · 2017: 6 · 2016: 5 · 2015: 6 · 2014: 6 · 2013: 9 · 2012: 5
FWCI
14.86
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords
Medicaid, access to outpatient care, outpatient care, appointment availability, emergency department utilization, urgent care centers, copayments, out-of-hours care, low back pain, dysuria, sore throat, health care costs
MeSH terms
Ambulatory Care, Emergency Service, Hospital, Health Services Accessibility, Humans, Informed Consent, Medicaid, United States, Urban Health, Confidence Intervals, Refusal to Treat

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