To the Editor: In the Health Agencies Update,1 Dr Hampton cites a report by the National Association of Community Health Centers2 and states that “[p]atients without health insurance are flooding US emergency departments.” We believe that this is an inaccurate description of that report, which focuses on the achievements and threats to community health centers.
The uninsured make up a minority of emergency department (ED) patients.3 An estimated 83% of emergency visits are by patients who have a usual source of health care other than an ED. Eighty-five percent of patients visiting an ED have medical insurance, and 85% have incomes exceeding the poverty threshold. Persons without insurance were no more likely to have had an emergency visit than those with private insurance, and individuals without a usual source of care were 25% less likely to have had an emergency visit than those with a private physician.
According to the National Center for Health Statistics, 15% of ED visitors are self-pay.4 While this amount of uncompensated care poses a significant financial strain for EDs, the majority of patients are not uninsured. In fact, a recent analysis by the Center for Studying Health System Change concluded that the increase in ED visits between 1996 and 2001 was primarily attributable to an increase in visits by the insured.5 The reality is that EDs serve as a “safety net” not just for the poor and uninsured, but for middle class Americans, particularly those with serious and chronic illness.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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