The Number One Reason We Head to the ER and Why It's a Problem

If it’s not an emergency, head for an urgent care clinic
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Do you pop an aspirin for a headache or run straight to the emergency room? Where do you go when you have a cold? According to the Washington Health Alliance, headaches are the number-one reason Puget Sound-area residents visit the ER.

And a 2015 study by the alliance reports that there are more visits to the ER for colds than for broken legs.

That’s a problem for a variety of reasons, reports the organization. It’s expensive: Avoiding unnecessary ER visits could result in a savings of at least $13 million per year to hospitals in the Puget Sound region. And it’s inefficient for patients: They must wait for ER staff to treat real emergencies first; they’re likely to be given more tests and procedures than they need; and the doctors they see are unfamiliar with their health history.

But getting fewer people to use the emergency room as a first line of defense for nonemergency issues, from sprains to the flu, has been surprisingly tricky. Urgent-care centers and walk-in clinics, often located in neighborhoods and drug stores, are a growing presence in the Seattle area. The hope is that these clinics will reduce the number of people using emergency rooms.

Yet recent surveys and studies show that nationwide, ER volume has increased since 2010. A 2015 survey by the American College of Emergency Physicians found doctors reporting an increase of 75 percent.

Several local partnerships are working to come up with ways to solve the problem. Group Health Cooperative and SEIU Healthcare NW Health Benefits Trust, which provides health care to home care workers via Group Health clinics, began a program in 2010 to reduce ER visit numbers for those workers, many of whom are minority, non-native speakers and suffering from a variety of conditions. The strategy focused on educating workers about the cheaper, faster urgent-care centers, which are better alternatives to the ER. The plan also urged workers, with the help of cash incentives, to be proactive in their own preventive care, such as scheduling screenings and checkups.

The information campaign has been effective, and Group Health reports that the home care workers have avoided nearly 1,200 unnecessary ER visits every year since 2010. Another coalition, called ER Is for Emergencies and developed in 2012, includes doctors, hospitals and the Washington State Health Care Authority, and targets frequent ER users in a campaign to educate patients about urgent-care clinic usage and to improve their access to primary care.

The group’s most recent progress report saw a decline in ER visits of 9.9 percent in 2013 and a savings of $33.6 million in Medicaid costs for emergency room care.