by
LAS
A
recent study by Truven Health Analytics found that 72 percent of
emergency room visits were avoidable, and could have been safely
treated by a primary care provider. Truven drew upon a database of 24
million patients.
Healthcare
situations were broken down into four categories of urgency. Category
One is Non-emergent; medical care was not required within 12 hours.
Category
Two is Emergent – Primary-Care Treatable; medical care was required
within 12 hours but could have safely been delivered in a primary
care setting (that is, in a clinic office).
Category
Three is Emergent, (preventable or avoidable); this means that the
patient needed medical care within 12 hours, for could have been
prevented with effective office visits. An example of the latter
would be someone who had diabetes or high-blood pressure who was not
taking their medication as advised, and suddenly had a sudden event
such as a stroke.
Category
Four is Emergent (not preventable or avoidable); these are the kinds
of events that people normally associate with an ER visit – a child
falls out of a tree, someone is a victim of a car accident or
shooting, someone is hit by a softball in a game, a homeowner falls
off the roof, etc.
Some
events were split between two categories, such as “abdominal pain,
unspecified site” since there is a 33 percent chance of it being a
serious problem requiring emergency treatment and a 67 percent chance
of being something that could be looked at in your doctor's office.
The
good news that only 6 percent of patients had an event that could
have been prevented with proper primary care. That suggests that
people are taking existing conditions seriously, taking their
medicine, and making sensible lifestyle decisions.
Almost
half (42 percent) could have been acceptably treated by their primary
care provider. No reason was floated for why patients did not go to
their physicians. Possibly they felt they could not get into a
treatment room in a timely fashion.
One
quarter had serious conditions but did not require treatment within
12 hours. Presumably they could have gotten into their primary care
provider within that time, or gone to an urgent care center.
When
broken down by age, it was shocking to see that three-quarters of the
visits by children age four and under were of a nature that should
have been seen in a primary care setting. Whether the parents had
health-care coverage for minors was not addressed in this report. But
still, these health events should have been seen in a primary care
setting by a pediatrician who was familiar with the child's
background.
Steering
patients to the proper non-ER setting would by itself create huge
cost savings for not only insurers but the patients, who presumably
would have come up with much larger copays for an ER visit.
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