Obamacare, Wider Health Insurance Access Could Lead to Pediatric Patient Influx

Signed into law by President Obama in March 2010, the Patient Protection and Affordable Care Act — popularly known as “Obamacare” — contains a number of provisions designed to expand health insurance coverage. Among these is the section of the law allowing children to stay on their parents’ insurance plans until age 26.

While good news for families and adult children struggling to afford medical insurance, such provisions have the potential to greatly increase the number of patients seeking care. How the healthcare system will cope with such an increase has been an open question.

A new study from The Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention (CIRP) examined the impact of more accessible health insurance. The study, which was published recently in Clinical Pediatrics, signals that healthcare providers may need to prepare for higher demand for treatment among younger patients with mild and moderate injuries. As policies encouraging broader health insurance coverage go into effect, the researchers see the potential for more than 730,000 additional medically attended injuries annually, or a 6.1 percent increase if all currently uninsured children and young adults become insured.

“This study signals a need to prepare for potential large increases in demand for care of minor and moderate pediatric and young adult injuries in both emergency department and outpatient settings,” said the study’s leader, Flaura K. Winson, MD, PhD, the Center for Injury Research and Prevention’s scientific director.

According to the study, a significant portion of the increase will come from currently uninsured young adults (18-26 year olds), who will now be able to remain on their parents’ health insurance until age 26 or find affordable care through exchanges.

The researchers also found that the causes and nature of medically attended injuries differed between insured and uninsured young adults. For example, the uninsured sought medical care for more serious injuries like fractures while insured patients sought medical care for a wider distribution of injuries. Among children under age 18, 11 percent of medically attended injuries among insured kids were related to overexertion, but uninsured children rarely sought care for this sort of injury.

The study estimates are based on recent injury care data and the assumption that those new to insurance would have a probability of medically attended injury that equals that of those who already have insurance. They predict that each year as many as 510,553 additional children and young adults could be seen for injury treatment in outpatient settings. Of those, an estimated 195,838 will visit emergency departments or will be admitted to the hospital, while another 30,689 will be attended through phone-only encounters.

To handle the increase in patients, the investigators recommend several steps to help avoid  overuse of emergency services and the long-term effects on communities of inadequately treated injury. These including training medical students and residents in the diagnosis and treatment of concussion, musculoskeletal injuries, and sports medicine, as well as working to prevent injuries to children and young adults by allocating funds to proven injury prevention strategies.

“Injury is the leading health risk for children and young adults. Proven prevention strategies and appropriate acute care will reduce fatalities and the long-term consequences that injury can have on quality of life,” said Dr. Winston.

To read more, see the full press release. And to learn about the work being done at the Center for Injury Research and Prevention, see CIRP’s website.