Due to access barriers, Americans seek a significant amount of non-emergent care in emergency departments, with long waits to be seen. Retail clinics and urgent care centers have emerged as alternative sites to the emergency department. We estimate that between 13.7 and 27.1 percent of all emergency department visits could be treated at one of these alternative sites with a potential cost savings of approximately $4.4 billion annually. The primary conditions that could be treated at these sites include minor acute illnesses, strains, and fractures. There is some evidence that patients can appropriately self-triage to these alternative sites.

This article focuses on racial and ethnic disparities in health care, describing both absolute differences and relative changes in access to care and the use of health services among whites, blacks, and Hispanics over the past two decades. Using data from a series of three nationally representative medical expenditure surveys, the authors present descriptive statistics on disparities in access and use between minorities and whites over time. They also use multivariate analyses to isolate the extent to which health insurance and income explain those disparities. The authors find that disparities increased between 1977 and 1996, particularly for Hispanic Americans. Results also show that approximately one half to three quarters of the disparities observed in 1996 would remain even if racial and ethnic disparities in income and health insurance coverage were eliminated.

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Each of the data sources described in this article has unique advantages and disadvantages when used to examine patterns of ED care, making the different data sources appropriate for different applications. Analysts should select a data source according to its construction and should bear in mind its strengths and weaknesses in drawing conclusions based on the estimates it yields.

In this article, we investigate the relationship between health behaviors, marital status, and gender in the elderly population. We estimate logistic regression models to determine the factors that affect the likelihood of undertaking healthy behaviors. Using data from the 1987 National Medical Expenditure Survey, we find that marriage has positive impacts on health behaviors in the elderly population and that, when these effects differ by gender, they tend to be larger for elderly men than for elderly women. These results extend earlier findings showing that marriage encourages healthy behaviors for a younger population and demonstrate that these benefits continue later in life.