A study has found most insured people are motivated by a sense of urgency — not a preference for convenience — to visit a hospital emergency department for care.
The findings are based on the 2012 Autoworker Health Care Survey, funded by the Center for Studying Health System Change and the nonpartisan National Institute for Health Care Reform. The survey of 8,836 active and retired nonelderly autoworkers and their spouses was conducted to learn how people decide to go to the ED.
Nearly a quarter of respondents (23 percent) reported having an urgent medical problem in the three months before the survey. Almost half (44 percent) of those with an urgent condition ultimately went to an emergency department for treatment.
Here are some of the study's findings:
Nearly half (49 percent) of respondents reported going to an ED partially because they believed their medical problem was an emergency that required immediate attention. Thirty percent of respondents indicated this was their sole reason for an ED trip — making it "by far the most common response," according to the study authors.
Only rarely did respondents cite convenience as a reason for choosing ED care, according to the study. About 7 percent indicated their use of an ED was driven partially by convenience, but less than 2.5 percent cited convenience as the sole reason for choosing an ED.
When they were first deciding to seek medical care for an urgent problem — either a new one or an aggravation of an existing problem — nearly half of all respondents first contacted their physician for help or advice. Twenty percent called 911 or went straight to the ED, and 17 percent first contacted or visited an urgent care center.
Roughly 25 percent of respondents said their physician's office was closed when they needed medical attention, and 24 percent said their physician told them to go to an ED.
Overall, the study found respondents who first contacted their physicians were much less likely to go to an ED than others. "Among the 75 percent of patients with an urgent need who contacted a doctor's office or clinic, nearly 60 percent were treated by a doctor or nurse in an office setting and another 12 percent were able to have their issue managed over the phone," according to the study.
The study authors concluded that expanding health coverage and linking patients to primary care practices may have less of an effect on insured individuals' ED use than expected unless there are improvements made to patients' access to lower-cost care settings that can provide a moderate intensity of care and urgent response time.
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