Only 3% of emergency room visits may truly be avoidable, study suggests

Emergency room doctor physician stethoscope scrubs Getty/gordonsaunders
Just a sliver of ER visits are truly avoidable, according to a new study. (Getty/gordonsaunders)

Though many emergency rooms are overcrowded and some patients may not have urgent needs, just a fraction of visits are truly “avoidable,” according to a new study.

Researchers examined data from the National Hospital Ambulatory Medical Care Survey from 2005 to 2011 that included more than 115,000 records representing 424 million emergency department visits, and found that only 3.3% were avoidable. The study team defined avoidable visits as those that did not require diagnostic tests, screenings, procedures or medications.

A number of these avoidable visits were for concerns that the ER is not equipped to treat, like dental or mental health issues, according to the study. Of the avoidable visits, 6.8% were for alcohol- or mood-related disorders, like depression or anxiety, while 3.9% were for dental conditions.

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The findings, published in the International Journal for Quality in Health Care, challenge the commonly held belief that many people visit the ER needlessly, said Rebecca Parker, M.D., president of the American College of Emergency Physicians, in an announcement.

“Despite a relentless campaign by the insurance industry to mislead policymakers and the public into believing that many ER visits are avoidable, the facts say otherwise,” Parker said. “Most patients who are in the emergency department belong there and insurers should cover those visits. The myths about ‘unnecessary’ ER visits are just that—myths.”

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The ER has been a frequent target for initiatives seeking to reduce overuse and the costs associated with emergency care. However, the researchers said that their findings point more toward the value in programs to improve patient access to services like mental health and dental care.

The study found that 10.4% of visits from patients with alcohol-related disorders and 16.9% of visits from patients with mood disorders were avoidable, suggesting that policymakers could do more to increase access to the services that would keep those patients out of the ER.

“Our findings serve as a start to addressing gaps in the U.S. healthcare system, rather than penalizing patients for lack of access, and may be a better step to decreasing ‘avoidable’ ED visits,” the authors wrote.