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The USF study did not specifically examine why the cost of uncompensated care rises at a higher rate as unfunded emergency department visits increase. But Dr. Orban offers two possible explanations:

First, emergency physician groups providing a higher percent of uncompensated care likely work in tertiary care hospitals with trauma, cardiac or stroke centers, she said. "The intensity of services required by sicker patients would result in higher average per patient charges and costs in the hospital's emergency department."

Second, emergency physician groups may set higher prices to try to offset higher levels of uncompensated care, Dr. Orban said, but the attempt to cost shift does not necessarily result in higher reimbursement rates from third party payers.

Emergency care for uninsured patients is an extremely important safety net in the health care system, the study authors conclude. "Intervention by policy makers is indicated to reduce and deter uncompensated care to avoid the negative effects of emergency department crowding on hospitals, physicians and patients and the closure of additional emergency departments."

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Contact: Anne DeLotto Baier
abaier@hsc.usf.edu
813-974-3300
University of South Florida Health
22-Dec-2005