Non-urgent ER visits: Some patients still receive diagnostic services, admission

Although triage services in emergency departments are meant to prioritize care to the sickest patients, a new study finds that in some cases, patients identified as non-urgent receive diagnostic services and procedures, and are even admitted to critical care units.

The study was published online today in JAMA: Internal Medicine.

Researchers, led by Renee Y. Hsia, M.D., of the University of California, San Francisco, analyzed 240 million ER visits, of which 17.8 million, or 7.5 percent, were triaged as non-urgent.  

In nearly half of the non-urgent cases, patients received diagnostic services, such as blood tests and imaging, and slightly more than 16 percent of the cases led to critical care admissions.

Triaging is not intended to completely rule out severe illness, the authors note. Instead, it was originally meant to predict the amount of time patients could safely wait to be seen in the ER.

"Certainly, not all of these data necessarily indicate that these services were required, and they could signal overuse or a lack of availability of primary care physicians. However, to some degree, our findings indicate that either patients or healthcare professionals do entertain a degree of uncertainty that requires further evaluation before diagnosis," the authors said in a study announcement.

Although many hospitals have opened urgent care centers or partnered with retail health clinics to keep non-emergency patients out of the ER, a March report found that nearly half of recent ED patients-many of whom have insurance coverage, went for non-urgent care. Some hospitals have responded by allowing patients to schedule appointments at the ER, FierceHealthcare previously reported.

To learn more:
- read the study abstract
- here is the announcement