Researchers from the University of Pennsylvania in Philadelphia worked closely with community health workers to interview 40 patients with low socioeconomic status about why they chose hospital or emergency care over primary care, according to a news release by Penn Medicine.
Many patients responded that they perceived the care was more effective, that the care was more accessible via ambulance and other types of transportation and that they could not afford to see a primary care physician and had to resort to hospital charity care. One-stop shopping for care at a hospital or emergency department seemed the easiest and least expensive route to addressing health needs for these patients.
Researchers also discovered that interviewees fell into two groups. One group used hospital or emergency care frequently because of traumatic events that stemmed from social dysfunction. The other used hospital or emergency care infrequently, but they used it when they had fallen very ill, possibly due to easily treatable conditions that worsened because of primary care visits that were postponed indefinitely due to time and transportation constraints.
The study authors commented that improving hospital care without addressing the factors that cause low-income patients to prefer hospital or emergency care over primary care might increase their preference for hospital care over primary care, which is at cross-purposes with the Patient Protection and Affordable Care Act’s goal of reducing avoidable hospital and emergency department visits.
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