Knowing When To Use (And Not Use) Emergency Rooms

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Sustaining an injury or feeling the sudden onset of sickness can be an alarming experience. In many instances, we instinctively seek out the emergency room as a vital provider of immediate care. However, according to a study from Mercer Human Resources Consulting, 35 percent of emergency-room users were unaware that they had alternatives for care.

When experiencing a change in health, knowing when to visit the emergency room, understanding your care options and having access to other resources available can save an unnecessary and time-consuming trip.

The number of hospital emergency departments has remained steady since 2001, while utilization has grown about 33 percent in the last decade. This means time spent at the emergency room is getting longer.

A California Health Care Foundation report, which tracked use over a 10-year period, found the average stay for patients not admitted to the hospital was almost three hours in California.

For patients being admitted to the hospital, they spent almost six hours in the emergency room beforehand. In fact, the Office of Statewide Planning and Development reported in 2017 that about 352,000 California visits ended after seeing a doctor, but before care was complete, as a result of crowded hospital emergency departments.

For life-threatening illnesses and injuries, you should always dial 911 or go to the emergency room.

If you aren’t sure if a visit to the emergency room is appropriate, your insurance company may offer a nurse line on the back of your insurance card to help you determine where you should get care. You also contact your health plan’s customer-service department to find a nearby urgent-care clinic or set up a time to see your primary-care doctor.

It’s important to understand when a visit the primary care doctor, urgent care or emergency room is the most appropriate.

A primary care doctor helps manage your health and provides the preventative care you may need. Your doctor can also treat minor illnesses and injuries — and refer you to a specialist, if needed.

Urgent care offers treatment for non-emergent injury and illness, such as allergies and the flu, asthma attacks, broken bones and cuts requiring stitches. They are first-come, first-served and provide a one-stop option for unscheduled, time-sensitive care.

Emergency rooms help people with life-threatening or dangerous conditions first. The emergency department is recommended for things you can’t control, such as bleeding that won’t stop, or if you lose consciousness or have trouble breathing. If you go there for a minor illness or injury, you may have a long wait.

Once you identify a care option, the timing is really up to you. Along with medical cost savings, avoiding the emergency room for non-emergent health concerns can help build a long-term relationship with a primary care doctor who can provide preventative care, treat minor illnesses and injuries, connect you to specialists and understand medical history for improved health outcomes.

Whether you are able to schedule a visit with your primary doctor to address your health issue or it requires immediate emergency room attention, it is important to have your photo ID and insurance information ready (don’t leave home without it!).

If you are visiting the emergency room, be prepared and have a list of medications you take on hand, a list of your allergies readily available, your phone and charger and your health record. Emergency rooms also carry the potential for higher germ exposure, so don’t forget a medical face mask (check the front desk) and hand cleaner (usually available in the department).

Checking into the emergency room can be a stressful situation, so knowing your options beforehand and arriving prepared can make a lengthy stay less hectic. To learn more about where you should go for care, visit www.uhc.com/knowwheretogoforcare.

Kevin Kandalaft is chief executive officer, UnitedHealthcare Community Plan of California.