Emergency Department Use by Medically Indigent Rural Residents

Many emergency department (ED) visits are not paid by third party payers but instead are paid out-of-pocket by the patient or remain uncompensated. Nationally, 15% of all ED visits were self-paid in 1998; in South Carolina during the same year, 26% of ED visits were self-paid. This burden is leading hospitals, including rural hospitals, to close EDs. The project will perform a cross sectional analysis of all ED use in South Carolina in 1998. "Medically indigent" patients will be defined as those for whom payor status is "self-pay" or "none." Findings from this analysis will be used to develop national estimates of the burden of uncompensated ED care in rural areas. In addition, South Carolina data will be studied to determine whether the presence of a federally qualified community health center or rural health clinic in the county reduces the burden of uncompensated ED care.

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