“Patients' perception of the severity of their medical problem and who they first contact for help or advice are the factors most associated with whether they seek emergency care,” the Center for Studying Health System Change report said.
About 30% of those surveyed who visited an emergency room said the only reason they did so was a belief that they urgently needed care. Only about 2.5% said their trip to the ER was solely for convenience.
Notably, the adults surveyed had insurance with benefits that were designed to discourage unnecessary emergency room use, with higher out-of-pocket costs for the emergency room than primary and urgent care.
The National Institute for Health Care Reform, a not-for-profit established by the auto industry and organized labor, funded the survey of autoworkers and industry retirees. The survey, conducted by Mathematica Policy Research, asked respondents about their use of the emergency department in the last half of 2012 and first two months of this year. Mathematica surveyed 8,636 non-elderly adults. The response rate was 64.2%.
Half of those surveyed who reported an urgent medical need in the prior three months said they first contacted a primary-care physician for advice. Of those, nearly 60% were treated outside the emergency room by a doctor or nurse, and 11% were cared for over the phone. Doctors sent slightly more than 1 out of 10 (12%) to the emergency room.
Respondents who sought care in the ED were less likely to report access to routine primary-care appointments “as soon as needed” or that doctors spent enough time with them.