Understanding the emergency room: Know when (and where) to go for care

Kevin Kandalaft is the CEO of UnitedHealthcare Community Plan of California. Courtesy photo

Sustaining an injury or feeling the sudden onset of sickness can be an alarming experience. In many instances, people instinctively seek out the emergency room as a vital provider of immediate care. However, according to a study from Mercer Human Resources Consulting, 35% of emergency room users were unaware that they had alternatives for care. When experiencing a change in health, knowing when to visit the emergency room, understanding care options and having access to other resources available can save an unnecessary and time-consuming trip.

The number of hospital emergency departments has remained steady since 2001, while utilization has grown about 33% in the last decade. This means time spent at the emergency room is getting longer. The California Health Care Foundation report, which tracked use over a 10-year period, found the average stay for patients not admitted to the hospital was almost three hours in California. For patients being admitted to the hospital, they spent almost six hours in the emergency room beforehand. In fact, the Office of Statewide Planning and Development reported in 2017 that about 352,000 California visits ended after seeing a doctor, but before care was complete, as a result of crowded hospital emergency departments.

For life-threatening illnesses and injuries, people should always dial 911 or go to the emergency room. If a person isn’t sure if a visit to the emergency room is appropriate, their insurance company may offer a nurse line on the back of the insurance card to help determine where to get care. They could also contact their health plan customer service department to find a nearby urgent care clinic or set up a time to see their primary care doctor. It’s important to understand when a visit the primary care doctor, urgent care or emergency room is the most appropriate.

A primary care doctor helps manage people’s health and provides the preventative care they may need. The doctor can also treat minor illnesses and injuries and refer patients to a specialist, if needed.

Urgent care offers treatment for non-emergent injury and illness, like allergies and the flu, asthma attacks, broken bones and cuts requiring stitches. They are first-come, first-served and provide a one-stop option for unscheduled, time-sensitive care.

Emergency rooms help people with life-threatening or dangerous conditions first. The emergency department is recommended for things that people can’t control, like if they have bleeding that won’t stop, if they lose consciousness or if they have trouble breathing. Patients who go to the emergency room for a minor illness or injury may have a long wait.

Once a care option is identified, the timing is really up to the patient. Along with medical cost savings, avoiding the emergency room for non-emergent health concerns can help build a long-term relationship with a primary care doctor who can provide preventative care, treat minor illnesses and injuries, connect them to specialists and understand medical history for improved health outcomes.

Whether a patient schedules a visit with their primary doctor to address their health issue or when seeking immediate emergency room attention, it is important to have a photo ID and insurance information ready. Don’t leave home without it. When visiting the emergency room, be prepared and have a list of medications the patient takes on hand, a list of their allergies readily available, a phone and charger and their health record. Emergency rooms also carry the potential for higher germ exposure, so don’t forget a medical face mask – check the front desk – and hand cleaner, which is usually available throughout the department.

Checking into the emergency room can be a stressful situation, so knowing the options beforehand and arriving prepared can make a lengthy stay less hectic. To learn more about where to go for care, visit www.uhc.com/knowwheretogoforcare.

Kevin Kandalaft is the CEO of UnitedHealthcare Community Plan of California.