Nearly half of recent emergency department patients feel their problems could have been handled by a physician’s office visit--had they had access to a physician--according to an issue brief published by the California HealthCare Foundation. The patient survey found four primary factors that drive increased ED use by insured patients who are not critically ill: lack of same-day appointments with a primary care physician or evening and weekend appoints, lack of advice on how to handle sudden medical problems, lack of alternatives to the ED (nurse advice lines or urgent care clinics), and positive attitudes about the ED as a site of care.
Medi-Cal patients were more than twice as likely as those with private insurance to have used ED services in the past year. And they were more likely than those with private insurance to believe that, compared to a doctor’s office, the ED provides a higher quality of care. Chronically ill patients also had disproportionately greater ED visits because they feel they have few alternatives for medical needs that occur at night or during the weekend.
The need for better communication between physicians and patients was apparent from the survey findings. While 76% of primary care physicians reported encouraging patients to contact them before going to the ED, only 35% of Californians confirmed that their doctor had done this. Similarly, most primary care physicians said they were able to accommodate all or almost of their patients requesting a same-day appointment, while more than half of Californians reported being unable to get a same-day appointment the last time they were sick or needed immediate care.
