Patients with higher medical excesses are less keen to visit ER
Research in the US shows that Americans who spend US$1,000 in out-of-pocket medical expenses were less keen to visit an Emergency Room (ER) for chest pain
Patients were also less likely to be admitted to hospital during these visits, compared to people who have health insurance plans with an annual deductible of US$500 or less, according to new research published in the American Heart Association's journal Circulation.
By 2020, more than half of US employees were enrolled in a high-deductible health plan with lower premiums but higher excesses, according to the national Employer Health Benefits Survey. It’s part of a growing trend towards health insurers and employers administering their own health plans, shifting the cost burden of health care to patients, researchers said.
The trend for consumer-driven healthcare
"Shifting the high cost of health care from insurers and employers to patients has become a trend across the US," said Shih-Chuan Chou, Emergency Care Physician at Brigham and Women's Hospital in Boston. "Our study is one of the first to examine the impact of a high-deductible health care plan on people's decisions to go to an ER for chest pain.
"People with higher deductibles delay treatment and are sicker when they show up in the ER for chest pain," Chou added. "When people with low incomes are switched to high deductible plans, they are disproportionately impacted financially and so is their health."
Each year, up to seven million people are cared for in an ER for chest pain and cost is a real factor when it comes to affecting outcomes. Researchers found:
- Switching to a high-deductible health plan was associated with a 4-per-cent reduction in ER visits for chest pain.
- Enrolment in a high-deductible health plan was associated with an 11-per-cent decrease in ER visits for chest pain leading to hospitalisation.
- Among low-income patients, those who had high-deductible health plans were nearly one third more likely to have a heart attack during a subsequent hospitalization 30 days after their initial ER visit for chest pain.
In May, Joe Cronin from International Citizens Insurance spoke to ITIJ about the role of the IPMI broker in adapting to the changing cover needs of globally mobile individuals during the global pandemic.