Evaluating the Difficulty in Finding Health Insurance Coverage and the Frequency of Hospital Emergency Visits Amongst Adults Living in California

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The United States spends roughly $3.8 trillion yearly on health care services, yet Americans bear the highest chronic disease burden compared to other high-income countries (Centers for Medicare and Medicaid Services [CMS], 2020). The poor healthcare system structure is affecting many Americans’ health, which is resulting in roughly $4.4 billion in unnecessary and preventable hospitalizations (Agency for Healthcare Research and Quality [AHRQ], 2018; Tikkanen & Abrams, 2020). Previous research examined the differences between educational attainment and understanding health insurance literacy and utilization; the affect of the Affordable Care Act (ACA) on health insurance coverage affordability; and insurance status and the frequency of emergency room visits. This study aimed to evaluate the differences between Californians' difficulty in finding health insurance and their frequency of self-reported emergency room visits in the last 12 months across socioeconomic (SES) categories as measured by federal poverty level. This research study utilized a cross-sectional approach and data from 2019 California Health Interview Survey. The sample size was 1,000 adults living in California, 442 males and 558 females. A Spearman’s correlational analysis and a one-way ANOVA were used to analyze the two research questions. This study revealed that there is no significant relationship between poverty level categories and difficulty in finding health insurance. The findings indicated that there is a significant difference between poverty levels categories and self-reported emergency room frequency. Further research studies should focus on how the American Rescue Plan alleviated the nation’s uninsured gap and whether this improved the health outcomes across poverty level categories.
A thesis submitted in partial fulfillment of the requirements for the degree Master of Public Health
Public Health, Public Policy