New York – Upstate New Yorkers made more than 640,000 trips to emergency rooms for sore throats, ear aches and other minor medical problems in 2008, raising concerns that such trips are straining already overcrowded ERs, according to a new Excellus BlueCross BlueShield report.
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About two out of five visits to upstate New York hospital emergency rooms in which patients don’t stay overnight are potentially unnecessary, according to the report, The Facts About Potentially Unnecessary ER Visits in Upstate New York.
“Unnecessary visits can strain overcrowded ERs, possibly delaying treatment for those who truly need an ER, and contribute to the rising costs of health care,” said Marybeth McCall, M.D., vice president and chief medical officer for Excellus BCBS. “We hope this report will help upstate communities work together on ways to address this problem.”
To determine the number of potentially unnecessary ER visits, the report applied a New York University formula that classifies ER visits to hospital data collected by the New York State Health Department.
According to the report:
One out of four ER visits in which the person is treated and released in the same day was for a medical issue that didn’t need care within 12 hours, such as back problems.
Another 18 percent of visits were for medical conditions that needed treatment soon — such as ear infections — but could have been treated in a primary care setting.
There is little regional variation in the percentage of potentially unnecessary ER visits in upstate New York.
A significant amount of health care dollars could be saved in upstate New York if patients went to their physician’s office instead of the ER for minor medical problems. Potential annual savings for commercially-insured patients range from $5.9 million to $8.6 million with a 5 percent change and from $29.3 million to $43.1 million with a 25 percent change.
People unnecessarily visit the ER at all hours of the day and every day of the week. Forty-five percent of such cases are seen between 9 a.m. and 5 p.m.
“The patient’s primary care physician should be at the center of the decision-making process when it comes to patients determining whether they should go to the ER for care,” McCall added. “It is important to talk to your physician about alternatives for care for those times when your physician is unavailable.”
The report highlights approaches being taken in other states to help people determine the best places to obtain care for minor medical issues. “There are many directions our community could go in responding to this data,” McCall noted. “The findings aren’t unique to upstate New York. However, all health care is delivered locally, so we believe the issue is best addressed by physicians, hospitals, health insurers, and other members of the health care system working collaboratively together.”
“If you’re having a true emergency, go to the ER,” McCall added. “But if you have a sore throat, an ear ache or back pain, you really should talk to your doctor. Your problem will usually be addressed more quickly and by someone who knows you best, and your co-pay for a physician visit will be less.”
About the analysis “Many of the figures in the analysis are conservative,” McCall added. “The number of potentially unnecessary ER visits in upstate New York is likely larger since the report did not include visits the NYU formula deemed ‘unclassifiable’ such as injuries.”
The report also looked at health insurer payments for care rendered to commercially insured patients to see how much would be saved if these patients went to a physician’s office instead of the ER for minor medical issues. More health care dollars would likely be saved if the analysis also looked at the uninsured and those with Medicare and Medicaid.
“The patient’s primary care physician should be at the center of the decision-making process when it comes to patients determining whether they should go to the ER for care,” McCall added. “It is important to talk to your physician about alternatives for care for those times when your physician is unavailable.”
What the government doesn’t get is that all those illegal aliens living Upstate don’t HAVE a primary care physican! They don’t have insurance!
As Michael Savage says, put a State Police Officer in every ER in the country and don’t allow sore throats in and maybe then this country will be on the right path!
are they referring to upstate as in summer time as in harris hospital? coz if so, i think that without the 2 months of summer ER visits they would not have enough money to stay open all year.
Actually the ER at the famous Harris University isn’t really good for anything more the a sore throat or ear ache
Upstate is a lot bigger then just the Catskills. The fact is that many regions upstate are tremendously short of primary care physicians, leaving people little alternative other then to go to the ER.
Perhaps (as well as other reasons written above me), people are les in touch with themselves, and society is less tollerant of people who have to rest or have aches and pains, and therefore, every little sore throat etc. IS an emergency!
When people look down on you, and don’t have patience for someone who feels run down, then this is an intollerable life situation.
This is the state of people today. There is too much going on all the time. Too much stress, not enough pleasure in everyday life, not enough time to start thinking about sore throats etc.
Most patients without insurance go to ER. As a rule that hospital cannot turn away the patients. Seeing primary physician is costly.
This has always been a problem. The solution is to spend half the money on minor medical clinics staffed with LPN’s and PA’s. Where is the common sense? Atlantis “insurance” company did it all over NYC.
check if they werent illeagle aliens