Emergency rooms are providing nearly half of all medical care in the US — and that may be a problem


A new study from researchers at the University of Maryland School of Medicine has found that nearly half of all medical care in the United States happens in emergency rooms — and it may mean that vulnerable populations aren’t getting care that meets all their needs.

The study examined data from 1996 and 2010 and found that emergency rooms provided, on average, 47.7% of medical care in the U.S.

Among certain populations, those numbers were even higher. African-Americans, women, and Medicare and Medicaid recipients, for example, were more likely to get their medical care at emergency rooms.

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Young patients drive themselves to the operating room at Rady Children's Hospital
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Young patients drive themselves to the operating room at Rady Children's Hospital
Andrea Destraio, 5, slaps hands with medical staff and invited police officers whose charity donated to Rady Children's Hospital to start a program that uses remote control cars to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake TPX IMAGES OF THE DAY
Doctor Daniela Carvalho uses a remote control device as Rady Children's Hospital unveil a program that uses remote control cars, donated by the local police officers charity, to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Andrea Destraio, 5, slaps hands with San Diego Harbor police officer Aldo Gutierrez and other officers whose charity donated to Rady Children's Hospital to start a program that uses remote control cars to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Doctor Daniela Carvalho controls Andrea Destraio, 5, remotely as Rady Children's Hospital unveil a program that uses remote control cars, donated by the local police officers charity to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Doctor Daniela Carvalho controls Andrea Destraio, 5, remotely as Rady Children's Hospital introduces a new program that uses remote control cars, donated by the local police officers charity, to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Doctor Daniela Carvalho controls Andrea Destraio, 5, remotely as Rady Children's Hospital unveil a program that uses remote control cars, donated by the local police officers charity, to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Doctor Daniela Carvalho controls Jonathan Jauregui, 7, remotely as Rady Children's Hospital unveil a program that uses remote control cars, donated by the local police officers charity, to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Doctor Daniela Carvalho controls Jonathan Jauregui, 7, remotely as Rady Children's Hospital unveil a program that uses remote control cars, donated by the local police officers charity, to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Doctor Daniela Carvalho controls Jonathan Jauregui, 7, remotely as Rady Children's Hospital unveil a program that uses remote control cars, donated by the local police officers charity, to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Doctor Daniela Carvalho controls Jonathan Jauregui,7, remotely as Rady Children's Hospital unveil a program that uses remote control cars, donated by the local police officers charity, to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Doctor Daniela Carvalho controls Jonathan Jauregui, 7, remotely as Rady Children's Hospital unveil a program that uses remote control cars, donated by the local police officers charity, to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Doctor Daniela Carvalho controls Jonathan Jauregui, 7, remotely as Rady Children's Hospital unveil a program that uses remote control cars, donated by the local police officers charity, to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Doctor Daniela Carvalho controls Jonathan Jauregui, 7, remotely as Rady Children's Hospital unveil a program that uses remote control cars, donated by the local police officers charity, to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Jonathan Jauregui, 7, leaves his room and wheelchair for an awaiting car as Rady Children's Hospital unveil a program that uses remote control cars, donated by the local police officers charity, to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Doctor Daniela Carvalho controls Jonathan Jauregui, 7, remotely as Rady Children's Hospital unveil a program that uses remote control cars, donated by the local police officers charity, to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
Dr. Daniela Carvalho (L) controls remotely as Andrea Destraio, 5, slaps hands with police officers who donated money to Rady Children's Hospital, as they unveil a program that uses remote control cars to take young patients to the operating room, in San Diego, California, U.S. September 19, 2017. REUTERS/Mike Blake
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“I was stunned by the results,” Dr. David Marcozzi, an author of the study and an associate professor in the UMSOM Department of Emergency Medicine, said in a statement from the university. “This really helps us better understand health care in this country. This research underscores the fact that emergency departments are critical to our nation’s healthcare delivery system."

According to Marcozzi, these findings mean that emergency rooms are providing vital care, especially for groups that face other barriers to accessing health care. “The data might suggest that emergency care provides the type of care that individuals actually want or need, 24 hours a day,” Marcozzi said.

According to Dr. Arefa Cassoobhoy, senior medical director at WebMD and senior medical correspondent at Medscape, the findings of this latest study also indicate that, while emergency rooms are providing necessary care, using them as a primary method of health care may mean that patients aren’t getting all their needs met — and that emergency rooms are becoming overcrowded.

“It’s not incredibly surprising reading this, but it is harsh looking at these numbers on paper,” Cassoobhoy said Tuesday.

Cassoobhoy said that it makes sense that so many people would turn to the emergency room for medical care. For people who face economic or language barriers that make it hard to access regular care, or for those with inadequate health insurance, “they can go there, and get their medical issues evaluated right there and then without having to go through the barriers of making an appointment.”

However getting care from an emergency room may mean that those patients are missing out on the kind of care that comes with seeing a primary care doctor. “The emergency room isn’t the place to meet that full spectrum of medical needs they may have … in terms of that long term relationship with a physician,” Cassoobhoy said.

It also means, she said, that an emergency room is “not working as efficiently as it could … because we’ve got so many people coming in for what isn’t an emergency.”

Cassoobhoy cautioned that the study only covered up to 2010, so its most recent data was from seven years ago, but the findings do indicate that more work needs to be done in addressing the needs of groups that are using the emergency room for their health care needs.

What needs to happen, Cassoobhoy said, is “really honing in on those populations and unpacking what the barriers are so we can address them systematically, that’s where we need to go.”

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