9 out of 10 New York hospital emergency room visits unnecessary

Image removed.Millions of New Yorkers use the emergency room for conditions that could be treated in less expensive settings, according to a new study conducted by Excellus BlueCross BlueShield. But a professional association of emergency physicians disputes the findings, calling the statistics flawed and misleading. 

Researchers examined 6.4 million visits made to New York state hospital ERs in 2013 and determined that more than two million were for common conditions such as ear or sinus infections and sore throats. They said nine out of 10 visits could have been avoided or treated elsewhere.

The cost of these unnecessary--or what the researchers describe as potentially preventable visits--was $1.3 billion, according to the study. Instead, patients could have saved time and money--and received better care coordination--if they sought treatment outside of the ER.

"The best method of care for nearly all of these cases is for patients to see their primary care doctors in office visits," said Jamie Kerr, MD, medical director, Excellus BCBS, in an announcement. "But when the physician isn't available, many of these potentially preventable ER cases can be addressed with telemedicine visits or going to urgent care centers at considerably greater convenience and less cost."

In an infographic that accompanied the study, researchers compared the average costs of a doctor visit, an urgent care visit and a telemedicine visit (about $49) to the average cost of a potentially preventable ER visit. The visit to the ER for a potentially preventable condition was nearly eight times the cost of seeing a doctor, 3.5 times the cost of an urgent care visit and about 15 times the cost of using telemedicine.

But in a statement issued today, the American College of Emergency Physicians (ACEP) and its New York chapter said the insurer used misleading data to draw inaccurate conclusions about whether emergency visits are appropriate. The ACEP argues the data is based on the patient's final diagnoses, not his or her presenting symptom. The conditions the insurer studied include symptoms that could be a more serious illness, the statement said.

"A report like this may discourage some people from visiting the emergency department who really should be there," said Jay Kaplan, M.D., president of the ACEP, in the statement. "The consequences of that could be (and has been) tragic."

To learn more:
- read the study
- here's the announcement
- check out the infographic
- here's the ACEP statement

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