Transcript HHIC.ORG Online Reports

Estimates of Hawai`i’s Uninsured
from Hospital Emergency
Department & Inpatient Data—the
Latest Update
The Hawaii Coverage for All Project
Technical Workshop VIII
January 30, 2006
Susan Forbes, DrPH
Jill Miyamura, PhD
Hawaii Health Information Corporation
Why does ED and hospital
data matter?
Extensive literature on the inferior
health status of the uninsured
 Extensive literature on the negative
impact that lack of insurance has on
the stability of the health system
 Evidence that the uninsured use the
ED for primary care
 Provides yet another view of the
issues involved

Data Sources

Data submitted monthly by hospitals
to Hawaii Health Information
Corporation
All emergency departments except
Tripler, Kahuku and Molokai
 All acute care hospitals (inpatient
data)

Uninsured ED Visits
10 %
8%
7.8 %
7.3 %
7.2 %
6.7 %
6.4 %
6%
4%
2%
0%
2000
2001
2002
2003
2004
Uninsured ED Visits by Sex
9,000
8,000
7,000
6,000
Female
Male
5,000
4,000
3,000
2,000
1,000
0
2000
2001
2002
2003
2004
Uninsured ED Visits by Sex
and Age, 2004
25 %
Insured
Uninsured
20 %
15 %
10 %
5%
0%
00-<01 Yr 01-04 Yrs 05-14 Yrs 15-24 Yrs 25-34 Yrs 35-44 Yrs 45-54 Yrs 55-64 Yrs 65-74 Yrs 75-84 Yrs
85+ Yrs
Uninsured ED Visits by
Island
25 %
2000
2001
20 %
2002
2003
2004
15 %
10 %
5%
0%
Hawaii
Kauai
Lanai
Maui
Molokai
Oahu
Top 10 Reasons for ED Visit
by Insured Status, 2002
Top 10 Reasons for ED Visit
by Insured Status, 2004
Inpatient Admissions from
ED by Status
18 %
16 %
14 %
12 %
Percent Medic aid/Quest
Percent Unins ured
10 %
8%
6%
4%
2%
0%
1996
1997
1998
1999
2000
2001
2002
2003
2004
Top 10 Reasons for Admission
from ER by Insured Status
2004
Preventable Hospitalization
by Insurance Status
Preventable Hospitalizations
by Payer
Preventable Hospitalizations
Charges by Payer
Preventable Hospitalizations
ALOS by Payer
Preventable Hospitalizations
by County
Preventable Hospitalizations by
County and Insured Status
ED Charge per Visit by
Insured Status
$1,200
$1,100
$1,000
$900
Insured
Uninsured
$800
$700
$600
2000
2001
2002
2003
2004
ED Charge per Visit by
Payer
$1,200
$1,100
$1,000
$900
Government
Private
Uninsured
$800
$700
$600
2000
2001
2002
2003
2004
Burden to the Hospitals

In 2004, charges to the uninsured
were over $64 million for ED and
inpatient combined
Top Reasons for ED
Infectious Disease
Diagnosis
Insured
Uninsured
Cellulitis
68%
81%
Viral Illness
23%
13%
Top Reasons for ED
Psychiatry
Diagnosis
Insured
Uninsured
Alcohol or
Drug Abuse
28%
46%
Acute Anxiety
24%
17%
Top Reasons for ED General
Medicine
Diagnosis
Sign &
Symptoms
Influencing
Health Status
Toxic Effects
of NonMedicinal
Substances
Insured
Uninsured
42%
51%
14%
12%
Questions?

Susan Forbes
534-1277
 [email protected]

MAHALO!!!