Using an emergency department (ED) for routine treatment is generally seen as a waste of health care resources and a contributor to rising health care costs.
But any employer hoping to be able to educate his or her employees about judicious use of the ED has to understand this is no easy task. Not even hospital employees have fully gotten the message. A recent study by Thomson Reuters found that hospital employees spent 10 percent more on health care and were 22 percent more likely to use the ED than employees in other industries.
“There are reasons that people continue to use the ED for non-urgent care,” says Dr. Stephen E. Perkins, vice president of Medical Affairs for UPMC Health Plan. “Understanding the factors behind the usage is an important first step toward reducing unnecessary ED visits.”
Smart Business spoke with Perkins about how to educate employees concerning ED use in order to reduce costs and improve care.
What are some reasons people like to use the ED for non-acute care?
Basically, when primary care is thought to be inadequate for the problem, and patients feel they cannot get timely care anywhere else, many will consider using the ED.
Getting in to see a primary care physician on short notice can be difficult, if not impossible, and physically getting to a physician’s office is a problem for some as well. In contrast, going to an ED means being seen — at least, initially — immediately. Transportation to an ED is often easier; some who arrive are even transported by ambulance.
Also, some patients ‘trust’ hospitals more than outpatient facilities such as urgent care centers. The sense that a hospital is the place for any serious ailment has been ingrained in many people over the years.
How big a problem is this?
A recent Rand Corporation study found 37 percent of all ED visits could be considered to be ‘non-urgent.’ The definition of non-urgent care may differ, but generally speaking, that statistic indicates many people are being treated in EDs who could be served as well, or better, in other settings.
What do employers need to do to engage and educate their employees about appropriate ED use?
Employers need to build awareness of ED alternatives. Employees need to know more about what urgent centers can and cannot provide. They also need to know that primary care can be a more viable option. Employers must educate employees about facilities such as urgent care centers, which are more appropriate for certain conditions.
Patients need to use good judgment in deciding whether to go to an ED. They need to learn the signs of serious illness and then trust their instincts.
When possible, calling a primary care physician and describing your condition is a preferable first step. If the physician is your regular physician, he or she will understand your health history and can direct you to the care that would be most appropriate.
What kinds of symptoms would warrant going to an ED and which do not?
It is appropriate to go to an ED if you notice symptoms like chest pains, trouble breathing, a head or back injury, persistent bleeding or vomiting, loss of consciousness, poisoning, a major burn or cut, or choking. For other medical emergencies such as a minor sprain, a small cut or a sore throat, treatment is better suited for an urgent care center or a primary care physician’s office.
Many physicians now have evening and weekend hours, so even if the office is not open, a doctor is on call. He or she can listen to your symptoms, taking into account your health history, to prescribe a course of action. This could include a visit to an ED or urgent care center, or the physician could schedule an office appointment or give instructions for treating a problem at home.
Employees also need to know that urgent care centers offer many similar services as EDs, such as X-rays and blood tests.
Why should employers take the time to educate employees about ED usage?
It is important to build awareness of ED alternatives because reducing non-urgent use of the ED, which in turn lowers health care costs, requires that you engage and educate people on how to choose appropriate care.
Insights Health Care is brought to you by UPMC Health Plan