Preventable Emergency Department Visits: Key Factors and Patient Characteristics

The emergency department plays a critical role in delivering urgent medical care to individuals facing acute emergencies, where every moment is critical. Yet, it’s evident that not every patient who arrives at our doors necessitates immediate attention. What motivates certain individuals to seek care in the emergency department for conditions that could be addressed elsewhere? Let’s delve into four key factors and patient characteristics driving this trend:

1. Lack of Access to Primary Care/Alternatives: In many cases, patients visit the emergency department for non-urgent conditions due to barriers to accessing primary care or lack of alternatives other than the nearest emergency department. For primary care, this could be due to long wait times for appointments, difficulty scheduling around work or simply not having a primary care doctor. According to the American Journal for Managed Care, lack of primary care or other appropriate options is a notable issue for patients presenting with mental health and substance abuse disorders.
2. Limited Healthcare Literacy: Limited healthcare literacy contributes to patients’ lack of understanding about the healthcare system and available alternatives beyond the emergency department. According to the Medical Care report on Potentially Preventable Use of Emergency Services – the Role of Low Health Literacy, this leads these individuals to turn to the emergency department for conditions that could be better addressed by primary care providers or urgent care clinics. This lack of understanding often prompts patients with chronic conditions to repeatedly utilize the emergency room instead of seeking more effective ongoing health management through alternative options.
3. Social Determinants of Health: Social Determinants of Health play a significant role in driving emergency department usage among vulnerable populations. According to a 2020-21 study by the U.S. Census Bureau individuals with lower income levels, lack of employment, and limited education, exhibit higher rates of non-urgent emergency department visits.
4. Lack of Health Insurance: Lack of Health Insurance is closely linked to unemployment. The aforementioned US. Census Bureau report indicates that individuals without health insurance are more likely to make preventable visits to the emergency room compared to those with insurance coverage. Uninsured patients often turn to the emergency department once health issues become urgent due to the absence of access to primary care.

Takeaway

Ensuring patients have viable treatment alternatives to emergency departments demands a comprehensive approach. This involves enhancing access to primary care, boosting healthcare literacy and tackling social determinants of health. To effectively allocate resources and provide appropriate care, collaboration among hospitals, community partners, policymakers and other stakeholders is imperative. By collectively addressing these underlying conditions, we can ensure that individuals receive the healthcare they require, thereby alleviating strain on emergency departments and prioritizing care for those facing genuine medical emergencies.