Estimating uncompensated care charges at rural hospital emergency departments

J Rural Health. 2007 Summer;23(3):258-63. doi: 10.1111/j.1748-0361.2007.00099.x.

Abstract

Context: Rural hospitals face multiple financial burdens. Due to federal law, emergency departments (ED) provide a gateway for uninsured and self-pay patients to gain access to treatment. It is unknown how much uncompensated care in rural hospitals is due to ED visits.

Purpose: To develop a national estimate of uncompensated care from patients utilizing the ED in rural hospitals.

Methods: Clinical data from the National Hospital Ambulatory Medical Care Survey-ED (NHAMCS-ED) from 1999 and 2000 were linked to billing data from South Carolina. National estimates of utilization and charges were calculated, with rurality and self-pay status being the variables of focus.

Findings: Applying South Carolina billing data to national clinical data yields a national estimate for 1999-2000 of nearly $441 billion in charges being generated through emergency departments, with self-pay patients representing 9.0% of total charges. Rural self-pay patients accounted for an estimated $3.5 billion in charges in 1999 and $5.3 billion in 2000. These charges may represent a total financial burden of more than $4 billion to rural hospitals.

Conclusions: Efforts should be made to reduce the uncompensated care burden on rural hospitals to ensure their viability. These efforts may include Medicaid/SCHIP expansions, FQHCs or RHCs, Critical Access Hospital Designation, or other indigent care programs that would reduce the need for self-pay patients to utilize EDs.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Demography
  • Emergency Service, Hospital / economics*
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Hospital Costs*
  • Hospitals, Rural / economics*
  • Hospitals, Rural / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Medically Uninsured / statistics & numerical data*
  • Middle Aged
  • Patient Credit and Collection
  • South Carolina
  • Uncompensated Care / economics*
  • United States
  • Urban Population