Annual Meeting Recordings are now available for purchase
303753
Impact of Primary Care Utilization on Emergency Room Use and Cost
Monday, November 17, 2014
Uncompensated care in US hospitals totals billions of dollars annually, and is directly influenced by the number of uninsured patients utilizing ERs. This quasi-experimental study analyzed the rate of usage and cost savings resulting from the availability of a local nonprofit primary care (PC) facility for uninsured patients in lieu of ER care in a small metropolitan area. ER data were gathered retroactively for 205 uninsured patients seen at one metropolitan hospital; and, PC clinic data were additionally gathered for 82 of them that received follow-up care at the PC clinic. Two years of ER data before initiation of PC clinic referrals (2008-2010) and two post (2011-2012) were gathered. Usage of the ER and PC clinics and their costs were compared for each group pre and post-referral. ER visits averaged 6.5 for the 2 years prior to referral and 4.0 for those who attended the PC clinic the 2 years post. ER costs averaged $2,260 for the study period, of which $1,733 was uncompensated. PC visits averaged $213 for the same time-period. For the 40% of patients (82/205) that utilized PC services this resulted in a projected hospital savings of $350,000+ from uncompensated care. ER visits are considerably more costly than PC clinics and their availability coincides with decreases in ER utilization and hospital financial losses from uncompensated care. However, the findings also illustrate the continued over utilization of ERs by the uninsured, even when other alternatives are available. An analysis of the issues will be presented.
Learning Areas:
Advocacy for health and health education
Provision of health care to the public
Public health or related public policy
Learning Objectives:
Describe the serious costs associated with over-utilization of emergency rooms.
Articulate the importance of the availability of primary health care providers for populations more likely to engage in emergency room over-utilization.
Identify the need for social workers to increase efforts in connecting clients with primary care services.
Keyword(s): Health Care Access, Health Care Costs
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I have completed an unpaid internship in a non-profit organization that provides health care to uninsured patients. All of the information presented will come directly from original research I conducted as part of thesis requirements for graduation from an MSSW program, as well as the existing literature on the topic.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
