Can the American health care system, slated to add 32 million more customers once federal reforms kick in, do a better job of keeping patients with non-critical problems out of the emergency room? That’s the question posed following a research paper published in Health Affairs that shows just how many people—insured and uninsured—are relying on the ER for acute medical care. In theory, if newly insured patients had access to primary care doctors, they would no longer need to use emergency rooms for non-emergency complaints.

 

Researchers determined that more than half of the 354 million doctor visits made annually for complaints such as stomach and abdominal pain, chest pain, and fever, are not with a primary care physician, and 28% are handled in ERs. Furthermore, more than half of acute care visits by uninsured patients were to emergency rooms, including almost all such visits on weekends and after office hours. This has increased the workload of ER staff and added to hospital costs.

 

Emergency doctors make up only 4% of the physician workforce, but take care of 11% of walk-in care visits.

 

A separate Rand Corporation study concluded that about $4.4 billion a year could be saved if the following conditions, among others, were shifted to retail clinics and urgent care centers: strains, fractures, back pain, skin problems, stomach pains, headaches, urinary tract infections, psychiatric conditions, lower-respiratory conditions, conjunctivitis and insect bites.

-David Wallechinsky, Noel Brinkerhoff

 

Quarter of Acute Care Delivered in ED (by Alicia Ault, Skin & Allergy News Digital Network)

Health Care Wastefulness Is Detailed in Studies (by Kevin Sack, New York Times)

Where Americans Get Acute Care: Increasingly, It’s Not At Their Doctor’s Office by Stephen R. Pitts, Emily R. Carrier, Eugene C. Rich and Arthur L. Kellermann, Health Affairs) (abstract)

Many Emergency Department Visits Could Be Managed At Urgent Care Centers And Retail Clinics (by Robin M. Weinick, Rachel M. Burns and Ateev Mehrotra, Health Affairs (abstract)