Office Visits Preventing Emergency Room Visits: Evidence from the Flint Water Switch

76 Pages Posted: 6 Apr 2020 Last revised: 6 May 2025

See all articles by Shooshan Danagoulian

Shooshan Danagoulian

Wayne State University - Department of Economics

Daniel Grossman

West Virginia University - Department of Economics

David Slusky

University of Kansas; IZA Institute of Labor Economics

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Abstract

Emergency department visits are costly to providers and to patients. We use the Flint water crisis to test if an increase in office visits reduced avoidable emergency room visits. In September 2015, the city of Flint issued a lead advisory to its residents, alerting them of increased lead levels in their drinking water, resulting from the switch in water source from Lake Huron to the Flint River. Using Medicaid claims for 2013-2016, we find that this information shock increased the share of enrollees who had lead tests performed by 1.7 percentage points. Additionally, it increased office visits immediately following the information shock and led to a reduction of 4.9 preventable, non-emergent, and primary-care-treatable emergency room visits per 1000 eligible children (8.2%). This decrease is present in shifts from emergency room visits to office visits across several common conditions. Our analysis suggest that children were more likely to receive care from the same clinic following lead tests and that establishing care reduced the likelihood parents would take their children to emergency rooms for conditions treatable in an office setting. Our results are potentially applicable to any situation in which individuals are induced to seek more care in an office visit setting.

Keywords: medicaid, lead, environmental regulation, emergency care

JEL Classification: H75, I12, I18, J13, Q53, Q58

Suggested Citation

Danagoulian, Shooshan and Grossman, Daniel and Slusky, David, Office Visits Preventing Emergency Room Visits: Evidence from the Flint Water Switch. IZA Discussion Paper No. 13098, Available at SSRN: https://ssrn.com/abstract=3568303

Shooshan Danagoulian (Contact Author)

Wayne State University - Department of Economics ( email )

656 W. Kirby
Detroit, MI 48202
United States

Daniel Grossman

West Virginia University - Department of Economics ( email )

Morgantown, WV 26506
United States

David Slusky

University of Kansas ( email )

1300 Sunnyside Drive
Lawrence, KS 66045-7585
United States

IZA Institute of Labor Economics ( email )

P.O. Box 7240
Bonn, D-53072
Germany

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