ED Utilization by Uninsured and Medicaid Patients after Availability of Telephone Triage

Abstract

Problem: For emergency departments experiencing crowding and a high percentage of patients leaving without being seen, a telephone triage service can provide other care options for low-acuity patients.

Methods: A nonexperimental pre- and postintervention comparative design was used to measure ED visit volumes from Medicaid and uninsured patients presenting with a low-acuity health care problem. Visit volumes for the 12 months before and 12 months after the initiation of telephone triage were compared.

Results: The overall low-acuity visit volume increased in the first 12 months of telephone triage availability. However, the proportion of low-acuity Medicaid and uninsured patients seeking ED care decreased. For the first 12 months of operation, telephone triage received 10,055 calls. Sixty percent of the calls (N = 6086) were from uninsured and Medicaid patients. More than 43% of the calls resulted in a self-care decision.

Implications for practice: A telephone triage service may help decrease ED crowding by communicating other care options to patients with low-acuity health problems.

Keywords: Crowding; Emergency department; Medicaid; Telephone triage; Uninsured; Utilization.