One of the major areas of concern to analysts observing the current health care crisis in the United States is that emergency rooms are being used more and more each year, at great cost to the health care system as a whole. The seriousness of this issue has caused some startling reactions among health care providers. In one case a hospital in California was forced to set up a tent outside the hospital in order to accommodate the number of people flocking to their ER. In a second example two hospitals in the state of Louisiana are fearful that their emergency rooms will not be able to handle the number of visitors who will begin to arrive once a third emergency room closes in the area.
What exactly is the appeal of the emergency room? After all, if you have ever been to visit one, and the chances are high that you have, considering that in 2009 emergency rooms handled over 119 million separate visits, there is very little to recommend it. The average wait to be seen by a physician is long; it varies greatly among hospitals, but can easily take an hour or sometimes much more before you are examined. Usually it is not a comfortable place to wait, especially considering that you are surrounded by some extremely ill people.
An argument has been made that the extreme overcrowding in emergency rooms is caused by many uninsured people using the ER as their primary care option. Since the uninsured can’t afford to see a doctor to treat the common illnesses of life such as colds, flu and a host of other ailments better seen by a doctor after making an appointment, they go to the ER for their routine treatment and care that they need; they do so knowing that they won’t be turned away just because they can’t pay.
This has proven to be just a theory, however, at least in the case of the state of Massachusetts. Recent reforms there have given all residents medical health coverage, but the rate of emergency room usage is still exceedingly high. This finding has surprised many people, especially those who believed that universal health insurance would curb the overuse/misuse of this facility. Since this hasn’t been the case in Massachusetts, according to a study done by the non-profit organization Urban Institute based in Washington D.C., analysts are now scrambling to explain these unexpected results.
According to some, the most probable explanation for the continued overuse of emergency rooms comes down to convenience. Anya Rader Wallack, the interim president of Blue Cross/Blue Shield of Massachusetts Foundation, a co-sponsor of the report, explains the finding this way:
“People having a stronger connection with a primary care doctor, people being able to get same-day appointments, and people being able to get after-hours care would potentially make a big difference,” Wallack said.
In other words, according to Wallack, the alternative to using the ER for primary care must also change. It’s not just a question of coverage, but of access; until people are happier with their primary care doctors and feel they can see them sooner at more convenient times during the day, the emergency room will still be inundated with non-emergency visits, at great cost to the health care system.
The study also found some interesting characteristics among those that use the emergency room as a substitute for the traditional primary care model. People from Massachusetts that used the emergency room at least three times within the past year were discovered to be:
o They are more ill and more disabled than people in the general population.
o They are more often among the low-income strata of society, or have less years of formal education.
o They tend to live in Boston or the southeastern part of Massachusetts.
o These frequent ER visitors account for almost 25% of the total annual visits to ERs in the state.
The emergency room is an amazing life-saving adjunct to the health care system, which is responsible for saving many thousands of lives in many different circumstances. However, by overtaxing the system, we risk diminishing the effectiveness of these emergency care centers. Therefore, it is important to become educated to identify true emergencies which require a visit to the ER, and when it is better to make an appointment to visit your doctor.
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