Healthcare News & Insights

Almost half of healthcare visits are to emergency departments – Why?

Emergency departments (EDs) play a significant role in health care, according to a new study from researchers at the University of Maryland School of Medicine. EDs deliver 47.7% of medical care, and that number rises dramatically when looking at marginalized populations. 

The study, published in the International Journal of Health Services, looked at medical care in America from 1996 to 2010 and found that half of it comes from EDs – and the number of visits steadily increased during the 14-year period.

Over that time, more than 3.5 billion healthcare contacts were made in EDs, outpatient facilities and hospitals. In 2010, there were almost 130 million emergency care visits across the country, compared to 101 million outpatient visits and 39 million inpatient visits.

And many of those visits came from people who’ve been traditionally underserved in health care.

Who uses emergency care more?

African-American patients were significantly more likely to use the ED than patients of other races – 54% of the time they went to the ED instead of using another option. In cities, that number rose to 59%.

Patients without insurance or with Medicare or Medicaid used emergency care more than other groups of patients, as did people in the South and West. Women were also more likely to go to the ED than men.

The authors of the study said this reflects a growing trend in use of the ED for members of vulnerable populations, which makes sense considering barriers to health care for marginalized patients.

They might not be receiving the best care, though, even if the emergency care is excellent.

Why patients visit so often

Dr. Arefa Cassoobhoy, senior medical director at WebMD, told AOL the study’s findings aren’t surprising, but patients’ needs aren’t always being met in the ED.

Emergency care has an obvious appeal for patients who can’t afford to make an appointment with a primary care physician or specialist, or who face language barriers, because they can “get their medical issues evaluated right there and then, without having to go through the barriers of making an appointment,” said Dr. Cassoobhoy said.

But the ED doesn’t allow for a long-term relationship with a physician, which can lead to problems for patients who might not notice certain changes to their health. Plus, EDs can get overcrowded and inefficient because so many people are coming in for non-emergencies (although busy EDs aren’t always a bad thing).

How did the ED become the main source of care for so many patients?

Experts say it’s a combination of things, from a lack of resources for patients to see outpatient and inpatient providers to limited effective prevention strategies.

Connect ED to providers

Lately, most healthcare systems and insurance companies want to cut down on unnecessary emergency visits for their patients.

However, the study’s authors said it might be a better strategy to connect the care delivered by the ED to the care provided by the rest of the healthcare system.

How to do that? UnityPoint Health’s St. Luke’s Hospital in Cedar Rapids, IA, has an idea. The hospital developed a program called Consistent Care. The program is overseen by a social worker and links patients in the ED with primary care physicians if they need them.

“The social worker sets the patient up with a primary care physician and works with them to follow through on the care plan,” said Peg Bradke, RN, MA, the hospital’s vice president of post-acute services.

That care plan is on file in the patient’s medical records, so if the person returns, the emergency department and primary care providers have the same plan to follow and reference.

Emergency care doesn’t exist in a vacuum, and it has an important and growing role in health care. Keeping it connected with other providers across the continuum of care helps patients get the treatment they really need, so they won’t have to rely on the ED as heavily.

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