Many Patients Make ER First Stop for Care

Image by Getty Images via @daylifeOf the 354 million acute care visits patients made to healthcare providers over a three-year period, more than one-quarter took place in emergency rooms, representing a shift from the old days when general practitioners were the main providers of acute care, a study found.

A study was published in Health Affairs, and found that, in part because of office-based practitioners' busy schedules, patients are increasingly going to the hospital for treatment for illnesses such as fever and stomach pain -- ailments which used to be treated in a doctor's office.

And fewer than half of all acute care visits involve the patient's personal physician, wrote the study authors, who were led by Stephen Pitts, MD, associate professor of emergency medicine at Emory University in Atlanta.

"Americans' access to primary care is in decline," the authors concluded.The authors laid out a number of possible reasons for the shift to the emergency room, including office-based primary care doctors not having enough time or space to keep up with patient demand, and fear of litigation driving primary care physicians to refer patients to a hospital.

From the study:

Stomach and abdominal pain, chest pain, and fever topped the list for most common reasons for visiting the emergency department, while cough, sore throat, skin rash, and earache were the most common reasons for visiting a family physician's office.

The study also broke down which types of doctors treated acute care patients and found:

• 28% of acute care visits were managed by hospital emergency departments
• 22% were managed family physicians
• 20% were managed by non-primary care office-based subspecialists
• 13% were managed by general pediatricians
• 10% were managed by general internists
• 7% were managed by hospital outpatient departments

"Apparently, primary care physicians provide much less acute care than in the past," the authors concluded, adding that using emergency rooms for problems a primary care provider could treat is "not desirable from a societal perspective."

"Too often, emergency care is disconnected from patients' ongoing healthcare needs," the authors wrote. "Lack of shared health information promotes duplicative testing, hinders follow-up, and increases the risk of medical errors."

The authors laid out a number of possible reasons for the shift to the emergency room, including office-based primary care doctors not having enough time or space to keep up with patient demand, and fear of litigation driving primary care physicians to refer patients to a hospital.

Link: http://www.medpagetoday.com/Washington-Watch/Reform/22085