19 September 2017

Large percentage of ER visits preventable

While some medical emergencies do require urgent care, many visits to the ER are for reasons that could have been avoided.

Each year, many ER visits in South Africa are for mood-related disorders, such as depression and anxiety. This is an alarming result of the lack of primary mental health care in SA.

A new study shows that there are numerous emergency room cases that could easily have been prevented. 

Insurers looking to cut back

ER visits could be reduced if patients had better access to dental and mental health care, according to researchers from the University of California, San Francisco.

The study comes as some insurers are looking to cut back on coverage for ER visits they deem "inappropriate" or avoidable.

Researchers reviewed 424 million ER visits by 18- to 64-year-old patients between 2005 and 2011. Nearly 14 million visits (3.3%) were avoidable, meaning patients were sent home without receiving any care.

The main reasons for avoidable visits were toothaches, back pain, headaches, sore throats and psychotic issues, the researchers said.

Nearly 17% of ER visits for mood-related disorders, such as depression and anxiety, were avoidable, as were 10.4% of alcohol-related visits, and nearly 5% of dental-related visits, according to the study. About 14% of the patients arrived by ambulance.

Main reasons for ER visits

The top causes of preventable ER visits in the United States include alcohol abuse, dental problems and mental health disorders such as depression and anxiety, the new study, which was recently published in the International Journal for Quality in Health Care says.

1. Alcohol abuse

Many visits to the ER were because of injuries or accidents that stemmed from alcohol abuse. Alcohol intoxication is also one of the reasons why people end up in the ER.

alcohol abuse

2. Depression

According to, people with depression often seek immediate treatment or hospitalisation in the ER, especially when they are a danger to themselves or others and having suicidal thoughts.

depression and suicide

3. Anxiety

When someone experiences a panic attack, they might not be aware that it's caused by anxiety and want to rule out other possibilities first.

woman having panic attack in car

Lack of access to health care

"Our study used a conservative definition of 'avoidable' to help physicians, policymakers and even insurance providers get a better picture of truly avoidable emergency department visits," study lead author Dr Renee Hsia said in a university news release. Hsia is a professor of emergency medicine and health policy at UCSF.

She said ERs aren't set up to treat some conditions that prompt patients to seek emergency care, but it shouldn't be assumed that the ER is inappropriate, either.

"We found that many of the common conditions of avoidable visits are mental and dental health-related, which emergency departments are generally ill-equipped to treat, suggesting a lack of access to health care rather than intentional inappropriate use," Hsia said.

She said the findings suggest that "policy initiatives could alleviate pressure on emergency departments by addressing gaps in dental and mental health care in the US, which could provide treatment to this group of visitors at a lower cost elsewhere."

Image credits: iStock


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