California Doctors Report Increase in Unnecessary ED Visits
As more California residents gain insurance through the Affordable Care Act, some emergency department doctors say there has been an increase in ED visits by patients who should be using primary care or urgent care services, U-T San Diego reports (Hutkin, U-T San Diego, 8/12).
Nearly 60% of Californians who were uninsured before Covered California's first open enrollment period have since gained coverage, according to a July survey by the Kaiser Family Foundation. Covered California is the state's health insurance exchange under the Affordable Care Act.
Specifically, the survey found that about 3.4 million previously uninsured Californians were enrolled in health coverage after the first open enrollment period (California Healthline, 7/30).
Details of Increased ED Admissions
Daniel Meltzer, chief of emergency medicine at Kaiser Permanente in San Diego, said, "What we're seeing is (patients) using the ED at a higher rate because they have insurance -- insurance causes resource utilization." He said that about 80% of patients who visit Kaiser's ED in San Diego are sent home instead of being admitted to the hospital.
According to U-T San Diego, a primary care shortage in the state also has led to greater use of EDs for conditions that could be better addressed elsewhere.
Keith Yablonicky, an attending physician at Sharp Memorial Hospital's ED, said patients often come in seeking emergency care for non-emergency conditions, such as:
- Chronic conditions, such as diabetes;
- Minor colds or coughs;
- Minor cuts or burns;
- Minor sprains, strains and injuries from sports or falls; and
- Prescription refills.
Yablonicky said, "We're a safety net for society, really ... we never tell (patients) to stay away from an ED," but he added that "resources in the ED are limited when a lot think they're unlimited" (U-T San Diego, 8/12).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.