Date of Graduation

Fall 2010


Master of Science in Nursing



Committee Chair

Rose Utley


emergency department utilization, ED overcrowding, uninsured Use of the ED, non-urgent Use of the ED, healthcare usage

Subject Categories



Emergency departments (ED) are overcrowded with both urgent and non-urgent patients. Overcrowding puts strain on EDs and can compromise quality of care. The ED is the safety net for access to care and is often used for basic primary care services instead of emergency healthcare. Insurance and the ability to pay for healthcare are major determining factors in where people seek care. The demographics of patients who utilize the ED are complex and not well understood. The purpose of this study was to investigate the acuity levels of patients in the ED as it relates to insurance status. This study explored ED usage patterns of the uninsured, privately insured, Medicaid insured, and Medicare insured patients. Data were collected through chart reviews from a hospital in Southwest Missouri. The results found that Medicare patients had the largest proportion of ED visits. The uninsured also had more ED visits when compared to those with private insurance. The majority of patients that were seen in the ED did have a primary care provider (PCP) and the uninsured represented the largest group without a PCP. Acuity level did not have a significant relationship to insurance status. There was no statistically significant relationship between acuity level and insurance status.


© Veronica Ann Putnam

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