The introduction of the Affordable Care Act (ACA) in 2010 allowed states to expand
the availability of public insurance to their citizens [
[1]
]. Thirty-five states ultimately adopted insurance expansion. It was widely anticipated
that the law would alter utilization of medical services. One of the surprising changes
has been an increase in the utilization of emergency department (ED) services for medical [
[2]
,
[3]
] and substance abuse services [
[4]
,
[5]
]. This increase occurred despite an increase in utilization of outpatient and preventative
services, but not for non-substance-related mental health services [
[6]
]. Similarly, homeless patients with substance abuse are more likely to utilize ED
services if they have public insurance [
[4]
]. However, the specific effect on general psychiatric ED utilization has not been
investigated.Keywords
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References
Anonymous. Patient protection and affordable care act: preexisting condition exclusions, lifetime and annual limits, rescissions, and patient protections. Federal Register 2010; vol. 75(123):37187–37241.
- Effect of the Affordable Care Act Medicaid expansion on emergency department visits: evidence from state-level emergency department databases.Ann Emerg Med. 2017; 70: 215-225.e6https://doi.org/10.1016/j.annemergmed.2017.03.023
- Emergency department utilization among the uninsured during insurance expansion in Maryland.Ann Emerg Med. 2018; 72: 156-165https://doi.org/10.1016/j.annemergmed.2018.04.025
- Substance use, homelessness, mental illness and Medicaid coverage: a set-up for high emergency department utilization.West J Emerg Med. 2018; 19: 902-906
- Characteristics and trends of emergency department visits in the United States (2010-2014).J Emerg Med. 2019; 56: 344-351https://doi.org/10.5811/westjem.2018.9.38954
- The effects of expanding public insurance to rural low-income childless adults.Health Serv Res. 2014; 49: 2173-2187https://doi.org/10.1111/1475-6773.12233
- Evaluating change: a simple technique for determining statistical significance of proportional criteria.J Healthcare Qual. 1994; 16: 14-17https://doi.org/10.1111/j.1945-1474.1994.tb00681.x
- Characteristics of patients with substance use disorder before and after the Affordable Care Act.Drug Alcohol Depend. 2018; 193: 124-130https://doi.org/10.1016/j.drugalcdep.2018.08.028
- The perceived impact of the patient protection and Affordable Care Act on North Carolina’s free clinics.N C Med J. 2016; 77: 23-29https://doi.org/10.18043/ncm.77.1.23
- Code red: the essential yet neglected role of emergency care in health law reform.Am J Law Med. 2017; 43: 344-387https://doi.org/10.1177/0098858817753404
- The impact of insurance coverage in diminishing racial and ethnic disparities in behavioral health services.Health Serv Res. 2012; 47: 1322-1344https://doi.org/10.1111/j.1475-6773.2012.01403.x
- The Affordable Care Act: disparities in emergency department use for mental health diagnoses in young adults.World J Emerg Med. 2017; 8: 206-213https://doi.org/10.5847/wjem.j.1920-8642.2017.03.008
- Effect of the Affordable Care Act’s young adult insurance expansions on hospital-based mental health care.Am J Psychiatry. 2015; 172: 182-189https://doi.org/10.1176/appi.ajp.2014.14030375
Article Info
Publication History
Published online: May 27, 2020
Accepted:
May 20,
2020
Received in revised form:
May 19,
2020
Received:
April 21,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
