Challenges to Accessing Healthcare in the Mississippi Delta: Analysis of Data from a Survey of Emergency Room Patients Seeking Non-Emergency Care

Many people utilize hospital emergency services for non-urgent health problems, at considerable cost to the health system and personal inconvenience. This study was conducted to gain insight into why children with non-urgent conditions use hospital emergency rooms (ER) instead of primary care. The study was a partnership among a provider of healthcare to underserved populations, university researchers, a hospital, and a community health center. Questionnaire-based interviews were conducted face-to-face with parents of children while they were waiting for their child to be seen at a local ER. The focus of the interview was the child. The questionnaire covered the general accessibility of primary care, insurance status, and specific barriers to access. Based on the first 53 completed interviews, 62% of patients were publicly insured (Medicaid or SCHIP); 12% were uninsured; 79% said the health condition for which they presented at the ER did not require immediate attention. Five percent reported that they used the ER because they could not take time off work for a healthcare visit and 19% responded that their regular provider was closed when they sought care. Fifteen percent reported they missed a child healthcare visit during the past year because they did not have transportation to a health provider while 8% cited inadequate health insurance as a reason for missed ambulatory pediatric appointments. Our preliminary data confirm that transportation is a powerful non-economic barrier to health access in this rural community, and that facilitating non-emergency health transportation and extending clinic hours could reduce unnecessary ER utilization.