To the Editor: In their article on uninsured adults presenting to US emergency departments (EDs), Dr Newton and colleagues1 discussed some of the assumptions regarding uninsured patients and ED use. One additional issue in ED use is a patient's identification of a usual source of care or a patient's identification with a clinician. This has been shown to have direct effects on use.2 It would therefore be interesting to know if the EDs were identified as a primary, usual source of care. Studies have also shown that prior contact with a health care system rather than current need of care was a key predictor of use.3
Prasad S, Klingner J. Uninsured Patients and Emergency Department Use in the United States. JAMA. 2009;301(11):1124–1125. doi:10.1001/jama.2009.274
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