Unnecessary trips to hospital ER cost $4.4 billion, study finds

About 17 percent of all hospital ER visits could be handled more quickly and cheaply at an alternative facility. The cost of the situation? $4.4 billion.
Written by Andrew Nusca, Contributor

We all know that some folks rush to their local hospital's emergency room for things that are, well, less than an emergency.

But how often does that happen, and how much is it costing us?

About 17 percent of visits to the ER in the U.S. could be treated elsewhere at retail medical clinics or urgent care centers, according to a new RAND Corporation study.

The savings if that occurred? About $4.4 billion. (Yes, with a "B".)

Most of us are aware of the idiosyncrasies of the healthcare system in the U.S., and there is not enough space in this blog post to detail them all. But the major point is as follows: there's a shortage of doctors in the U.S., and not enough hours in the day to see patients -- so when a condition arises, some folks skip the limited hours and long lead times for appointments and head to the ER.

The problem is that, for some of these trips, the ER is no place to go: there are still significant wait times (so much for "emergency") and worse, it will cost a small fortune -- for both the patient and taxpayers at large -- when it's over.

What RAND social scientist Robin Weinick and University of Pittsburgh professor Ateev Mehrotra suggest in the study is that patients ought to consider seeking out retail clinics -- the ones located in pharmacies or grocery stores, which are usually staffed by nurse practitioners who can handle urinary tract infections or sore throats -- or urgent care centers, which are staffed by physicians and can handle more serious conditions, such as minor fractures and serious cuts.

Both facilities tend to be open in the evenings and on weekends and can handle surprise visits. Better still, they're "substantially" cheaper than the ER.

In the study, researchers analyzed information about patients who visited retail medical clinics and urgent care centers and compared it to profiles of patients who visited hospital emergency rooms in 2006.

What they found is that 13.7 percent of the ER visits in the survey could have been treated at a retail medical clinic from an injury point-of-view; the figure drops to 8 percent if you restrict those to when retail clinics are typically open.

Moreover, the researchers found that an additional 13.4 percent of all hospital ER visits could be treated at an urgent care center. Again, the figure drops to 9 percent if urgent care center hours are taken into consideration.

Overall, that means that 27.1 percent of all hospital ER visits could have instead been managed at a retail clinic or urgent care center. When taking office hours into consideration, 16.8 percent or ER visits could have been rerouted to an alternative facility.

One caveat about the study's findings: it did not evaluate whether retail clinics and urgent care centers currently have the capacity to handle substantially higher numbers of patients.

Nevertheless, the data is an early look at quantifying the holes in the U.S. healthcare system. With more knowledge, service gaps can be closed.

This post was originally published on Smartplanet.com

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