Unnecessary, inappropriate ER visits hard to determine

From AMA Member Communications

In a news analysis, the UPI (5/19, Pierce) reported that although "health-care reformers say the U.S. can save a lot of money by reducing unnecessary emergency-room visits," two studies presented at the Society for Academic Emergency Medicine Annual Meeting "found that it is difficult to define what an 'unnecessary' or 'avoidable' ER visit is, and reducing those visits may not actually save a lot of money."

In the first study, researchers "examined Oregon emergency-room data before and after significant cuts in 2003 to the state's Medicaid program." While they found "a significant increase in emergency-room visits from uninsured patients, they were unable to easily divide them into categories of non-emergency, emergency, emergencies that could have been avoided with timely primary care and emergencies that could be treated if timely primary care were available." Another study "suggests there is little money to be saved from cracking down on unnecessary emergency-room visits.

During the same time period in Oregon, only 6.8 percent of Medicaid dollars were spent on emergency care, and four out of five beneficiaries never went to the emergency room at all." Eileen Moore, director of the Health Rights Project at the Georgetown University School of Medicine, told the UPI, that the "causes of patients seeking primary care in emergency departments may also range beyond simple lack of affordability. Transportation, safety concerns and work schedules also play a role - even for patients that are insured."