BOSTON GLOBE: When the Massachusetts Legislature made health insurance mandatory five years ago, supporters of the first-in-the-nation law hoped it would keep patients out of hospital emergency rooms.

Patients with insurance, the theory went, would have better access to internists, family practitioners, and pediatricians, lessening their reliance on emergency rooms for routine care.

There is more evidence today that it did not turn out that way.

Three-quarters of Massachusetts emergency room physicians who responded to a survey last month said the number of patients in their ERs climbed in the last year.

They cited ”physician shortages” along with a growing elderly population as the top two reasons why more patients come to ERs.

The law ”didn’t create an infrastructure,” said Dr. David John, chief of emergency care at Caritas Carney Hospital in Boston. “Doctors offices are full to capacity.”

The number of doctors who responded to the survey by the American College of Emergency Physicians — 56 from this state — is small. But their responses echo findings from last July, when state health officials found that ER visits rose 9 percent from 2004 to 2008, to about 3 million visits a year.

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