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Why Do We Continue Using the ER for Care

Posted By US Health, Tuesday, January 5, 2016

Access to health care is one of the hottest topics in society today. As a nation, we have worked feverishly to find the perfect health system that ensures our citizens can get medical care whenever it's needed.

In a society that gets its news 140 characters at a time, we are now a generation of immediate information, training and activity. This extends to the health care system more than ever in our history. Finding ways to allow immediate, convenient access to medical care now includes an olio of options, from the  doctor's office and urgent care centers to clinics in large retail chains. It also, of course, includes the old standby: the emergency room. With so many choices, it can be difficult to know how best to access medical care in the U.S. today.

According to the Centers for Disease Control and Prevention, ER visits increased by 20 percent in the first decade of the new millennium. That translates to about 136 million visits per year. One in 5 Americans will visit the ER at least once annually. Of those trips, only 12 percent will result in admission, meaning many of those visits, as many as 65 percent, are deemed unnecessary. The result is very costly in terms of both time and money. 

ER visits are about four times as expensive as other ambulatory visits and take an average of four to five hours versus the usual one-hour visit in other venues. Billions of dollars in health care costs, along with 65 percent waste and endless hours of work and school time lost occur as a result. 

So why do we continue using the ER for care? Convenience, mainly. For children, about 75 percent of their visits occur on nights and weekends, when the primary care physician is not open. Most of these visits are related to respiratory illnesses. Most adults show up for injuries, certainly unplanned and not likely to fit into a scheduled appointment. 

Other more optimal options exist for care. The most important health care relationship remains the bond between the patient and primary care provider, or PCP. This type of medical home is critical to having a long-term health plan versus one based on crisis intervention. However, there are several limitations to this time-honored method of health care delivery: Inconvenient hours, lack of on-site diagnostics and off-site pharmacy requirements make one-stop shopping in this setting difficult, a departure from what we've come to expect in the supermart world of today. 

Several alternatives exist to the PCP office and ER. Urgent care centers have become a staple across the country. While not open 24/7 like the ER, evening and weekend hours make them an attractive option. These venues usually have a 30- to 60-minute wait time and an average bill of $60. Limited diagnostics are often available, such as strep tests, urinalysis and plain X-rays. Generally staffed by physicians or nurse practitioners, these venues are great for common illnesses such as colds, flu, low-grade fever, earaches, sore throat and mild rashes, to name a few. 

New to the market are the chain store clinics. Originally started as a way to entice customers into the store, these clinics are quickly becoming an alternative to the PCP and urgent care centers. Many of these clinics can diagnose and manage acute illnesses, and supply first-aid items, durable medical equipment and even fill prescriptions right in the store. In addition, significant efforts in detecting and preventing chronic illnesses (think: vaccines) can be done in this setting. These clinics definitely cater to the one-stop shopping lifestyle that a busy world desires and requires.

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