Emergency Room Visits by Uninsured Child and Adult Residents in Ontario, Canada: What Diagnoses, Severity and Visit Disposition Reveal About the Impact of Being Uninsured

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• 作者：Michaela Hynie ; Chris I. Ardern…
• 刊名：Journal of Immigrant and Minority Health
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：18
• 期：5
• 页码：948-956
• 全文大小：1,191 KB
• 刊物主题：Public Health; Sociology, general; Private International Law, International & Foreign Law, Comparative Law;
• 出版者：Springer US
• ISSN：1557-1920
• 卷排序：18

文摘

Canadian immigrants can be without health insurance for many reasons but limited data exists regarding uninsured health outcomes. Uninsured Canadian residents were identified in the National Ambulatory Care Reporting System for all visits to emergency departments in Ontario, Canada between 2002/3 and 2010/11 (N = 44,489,750). Frequencies for main diagnoses, severity (triage), and visit disposition were compared. Ambulatory care sensitive conditions were identified in a 10 % subsample. The uninsured (N = 140,730; 0.32 %) were more likely to be diagnosed with mental health (insured: 3.48 %; uninsured: 10.47 %) or obstetric problems (insured: 2.69 %; uninsured: 5.56 %), be triaged into the two most severe categories (insured: 11.2 %; uninsured 15.6 %), leave untreated (insured: 3.1 %; uninsured: 5.4 %), or die (insured: 2.8 %; uninsured: 3.7 %). More ACSC visits were made by uninsured children and youth. Insurance status is associated with more serious health status on arrival to emergency departments and more negative visit outcomes.KeywordsHealthcare accessEmergency departmentHealth equitySocial determinantsImmigration