title: Emergency Room Visits by Uninsured Child and Adult Residents in Ontario, Canada: What Diagnoses, Severity and Visit Disposition Reveal About the Impact of Being Uninsured.
abstract: Canadian immigrants can be without health insurance for many reasons but limited data exists regarding uninsured health outcomes. Uninsured Canadian residents were identified in the National Ambulatory Care Reporting System for all visits to emergency departments in Ontario, Canada between 2002/3 and 2010/11 (N = 44,489,750). Frequencies for main diagnoses, severity (triage), and visit disposition were compared. Ambulatory care sensitive conditions were identified in a 10 % subsample. The uninsured (N = 140,730; 0.32 %) were more likely to be diagnosed with mental health (insured: 3.48 %; uninsured: 10.47 %) or obstetric problems (insured: 2.69 %; uninsured: 5.56 %), be triaged into the two most severe categories (insured: 11.2 %; uninsured 15.6 %), leave untreated (insured: 3.1 %; uninsured: 5.4 %), or die (insured: 2.8 %; uninsured: 3.7 %). More ACSC visits were made by uninsured children and youth. Insurance status is associated with more serious health status on arrival to emergency departments and more negative visit outcomes.
authors: Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada. mhynie@yorku.ca.
authors: Michaela
authors: M
authors: Hynie
authors: School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
authors: Chris I
authors: CI
authors: Ardern
authors: Queen West-Central Toronto Community Health Centre, 68 Bathurst Street, Toronto, ON, M5V 2R4, Canada.
authors: Angela
authors: A
authors: Robertson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008603:Mental Health / Q000706:statistics & numerical data; D008875:Middle Aged; D009864:Ontario; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Emergency department; Health equity; Healthcare access; Immigration; Social determinants