Do patients really need to go the ER?

Eighty-five percent of Americans who have been to the emergency department said they couldn't wait to see their regular medical provider, according to a recent Harris poll from the American College of Emergency Physicians (ACEP).

"The poll results show that emergency departments are filled with patients who feel they need to be there," the ACEP statement said. "People are coming because they need care and if they have a non-urgent condition, such as a bladder infection, it's because they have no place else to go and the problem feels like an emergency to them."

Why are patients going to the ED? It may be because their primary care provider sent them there.

Despite efforts to curb nonurgent and unnecessary use, one in five patients (20.1 percent) who went to the ED and weren't admitted said it was because their primary care provider sent them, according to the Centers for Disease Control and Prevention report.

"Either they see the patient, and say, this is beyond what I can do in my private office, with limited resources, or they talk to the patient on the phone and say I'm concerned about your symptoms," Andrew Sama, president-elect of the ACEP, told HealthLeaders Media about provider referral. "Or they know the patient has complex problems with subtle symptoms that can mean grievous issues, and they send them to us because we can do the diagnostic testing rapidly, or call on a colleague or specialist to get more detail."

Using data from January to June 2011 from the National Health Interview Survey, the CDC found that emergency room visits resulted from a lack of access to care, with nearly 80 percent of adults who visited the ER reporting they didn't have access to other providers. For instance, about half (48 percent) reported that they went to the ER because the doctor's office was closed, and 46.3 percent said there was no other place to go. Some (45.8 percent) said they went to the ER because it was the closest provider.

Sixty-six percent headed to the ER because of the seriousness of the medical problem, with 54.5 percent saying that only the hospital could help them, according to the CDC.

The CDC data follows this month's report conducted by HealthLeaders Media, in which hospitals are reporting that patients often view the ED as their only option. Almost half of healthcare leaders say their ED is overcrowded, and 51 percent of those worry it will jeopardize patient safety.

As a result, hospitals are using urgent care facilities, creating freestanding EDs or opening up after-hours clinics to better utilize emergency services.

To learn more:
- see the ACEP poll announcement
- read the CDC report (.pdf)
- see the HealthLeaders Media article

Related Articles:
HIEs aim to curb ED overuse
Half of EDs overcrowded, leaders report
ERs to see more visits with changes in health insurance status
Hospital-clinic partnership aims to reduce ER overcrowding, costs
After-hours clinic reduces hospital ER crowding

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