People who have no health insurance often go to their local emergency rooms for primary care issues. ERs often treat patients for chronic conditions like asthma and diabetes in lieu of a primary care doctor.
In some ways, the reliance of uninsured patients on ER care causes big problems for hospitals. ERs have a statutory requirement in most areas to provide care whether or not patients can afford it. For this reason, hospitals often have to foot the bills for billions of dollars in charity care each year.
An ER's core mission is to evaluate and stabilize seriously injured or ill patients. However, according to a recent study published by the RAND Corporation, most patients who enter the ER come in through the door and walk out the same way, largely because of a lack of availability of other timely treatment options.
Limited options could become even more limited because of a shortage of primary care doctors in America. In a recent opinion piece for Politico, Sen. Bernie Sanders (I-Vt.) cited a statistic saying that the country needs 16,000 new primary care doctors to address today's gaps in care. The problem will get worse when the Affordable Care Act brings 30 million more Americans into the system.
On the one hand, pretty much all of the growth in hospital admissions rates over the past decade have come from ER patients. These admissions generate income for hospitals, but they also burden the healthcare system. Inpatient care makes up 31 percent of U.S. healthcare costs, according to RAND.
On the other hand, ERs are helping hospitals to curb preventable admissions. The Healthcare Cost and Utilization Product (H-CUP) found that preventable admissions, which are hospital admissions that could be prevented by high-quality primary care and preventive care, dropped 6.2 percent for adults and 40 percent for children.
The RAND study found that ERs are doing many primary care tasks such as working up complex diagnostic studies that primary care physicians don't want to handle within their offices. By providing high-quality care to these patients, ERs could be curbing costly inpatient admissions.
Until more options are available, Americans will continue to seek primary care at the ER. The RAND study shows how emergency departments are playing an increasing role in the modern healthcare system.
Edited by
Alisen Downey
