The impact of resident physician coverage on emergency department visits in South Carolina.
BACKGROUND
This study examines emergency department (ED) visits to assess the potential impact on rural and minority patients if the practice of resident moonlighting was limited.


METHODS
Billing data from all South Carolina ED visits in 1998 were linked to the physician licensure file. Logistic regression analysis was performed to determine patient characteristics predictive of being seen by a resident physician.


RESULTS
Resident physicians attended 3.4% of visits for patients residing in rural areas and 1.4% of those from urban areas. The odds of being treated by a resident were higher among persons living in health professional shortage-designated or rural areas, minorities, and persons with government insurance.


CONCLUSIONS
Patients from vulnerable populations have greater odds of being seen by a resident physician for an ED visit. These populations may be placed at risk for reduced access to health care services if limitations on resident physician moonlighting impair the ability of rural hospitals to staff EDs.
Bennett
Kevin J
KJ
Department of Health Administration, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. bennett@sc.edu
Baxley
Elizabeth
E
Probst
Janice C
JC
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007396:Internship and Residency / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008484:Medicaid; D008507:Medically Underserved Area; D008875:Middle Aged; D015999:Multivariate Analysis; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D010821:Physicians, Family / Q000706:statistics & numerical data / Q000600:supply & distribution; D012424:Rural Population; D017678:Sex Distribution; D013022:South Carolina; D044465:White People / Q000706:statistics & numerical data; D000078329:Workforce; D001741:Black or African American