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Children, mental illness & insurance: A study on ED admissions

Does health insurance impact whether a child will get emergency medical care? According to researchers who recently finished a study into the matter, if the child has a mental disorder then the answer is a resounding yes. The researchers reviewed 9,081 acute mental health emergency department (ED) visits. Based on a review of this data, the researchers found children without insurance were much more likely to get transferred compared to children who were covered by a private insurance policy.

Is this a new problem?

Unfortunately, no. The American Academy of Pediatrics along with the American College of Emergency Physicians has called on hospitals to address similar issues in the past. The two released a joint statement in 2006 to provide guidance. Researchers conducted this study to support this previous report and continue to push for change.

What was the goal of this study?

The researchers called on physicians and other medical professionals within the hospital setting to advocate for change. They stated change was needed to better ensure children who suffer from mental health emergencies are not subject to disparities in access to care due to the fact that they are not covered by a private insurance provider.

What does this mean for emergency departments and hospitals?

In some cases, hospitals that fail to provide care in line with applicable rules and regulations can face government scrutiny. An investigation can result and could lead to allegations the facility violated the Emergency Medical Treatment and Active Labor Act. If the government can support these allegations, steep financial penalties and additional charges. As a result, this study can serve as a reminder to review your facility’s best practices and make changes to ensure they are in line with applicable regulations.