Emergency departments strained by patients better seen elsewhere

The uninsured often do not take advantage of community services that are available, and other services are simply not accessible.

By Joel B. Finkelstein, AMNews staff. June 21, 2004.

Washington -- Hospital emergency departments are being overburdened with uninsured patients partly because these patients are unaware of primary care services available in their communities, says a new report from the Urgent Matters program at George Washington University.

Researchers with Urgent Matters, which is funded by the Robert Wood Johnson Foundation, found that severely restricted access to specialty care and mental health services and almost nonexistent dental care are driving many more patients to seek attention in emergency departments.

"When we started this project, we expected to see gaps, but not to see them as large and as prevalent as they were," said the program's director, Bruce Siegel, MD, MPH.

One-fifth of patients coming to the ED did not have conditions requiring emergency care, and another one-fifth had urgent conditions that could have been treated in a primary care setting, the report shows.

"In reality, the emergency department serves as the safety net for the safety net," said Marsha Regenstein, PhD, the report's author. "For some patients, it's their only source of care and the only option for timely care."

Uninsured and Medicaid patients in some communities might have to wait six months or more for an appointment with a specialist. But if they go to an ED, they get all their needs met in one place at any time.