Emergency Dept, Outpatient Clinic, and Primary Care Provider visits on the rise.
Ambulatory healthcare utilization continues to rise. Physician office, emergency department, and outpatient clinic visits are all increasing. Statistics from the National Center for Health Statistics show that there were 1.2 billion patient visits to primary care provider (PCP) offices, hospital outpatient clinics, and emergency departments (ED) in 2005, (a rate of 4 visits per person annually). Visit rates per population have all increased over the past decade and continue to do so.
Emergency department visit rates have about doubled for patients with no healthcare insurance compared to those who are insured. Not surprisingly the opposite is true of PCP office visits where patient visits were higher for those with insurance.
Approximately 30% of all visits were for chronic medial conditions such as cardiovascular disease and diabetes. Only one out of four visits was for preventive care. A staggering 2.4 billion medications were prescribed or administered during these visits, the number one medications class was antidepressants. This is disappointing and concerning, but not surprising.
When looking at numbers from the report put out by the Center it is difficult to fully comprehend the enormous cost associated with healthcare services today. One can see that in the absence of health insurance people are forced to use their local emergency department as their primary source of healthcare. This helps explain the dramatic increase in ED patient visits for those without adequate health insurance. It is no wonder why so many hospitals are carrying millions and millions of dollars of bad debt year after year.
The report goes on to state that emergency departments saw approximately 1.8 million patients for adverse effects of care during the study period. Almost 60% were for medical and surgical complications with just over 40% for adverse drug reactions. Complication rates associated with procedures such as surgical-site infections and postoperative bleeding have increased fourfold for patients aged 65 and older.
Once again we see patient safety as a high profile issue embedded in the statistics. Complication rates, infections, and the like have been the impetus for many hospitals to adopt transparency programs as a way of communicating quality of care to the public, as well as promoting internal organizational motivation for providers to be better.
Some may be thinking yes we know the picture is grave for healthcare. Patients are experiencing longer wait times at local emergency departments. As a result patient safety is thwarted and there is an increased risk of poor patient outcomes. Most patients are finding it difficult to make timely appointments with their PCPs. Finally, the demands placed on hospitals today are causing serious cracks in the foundation of the healthcare. Unfortunately the current state of healthcare is likely to worsen before it gets better.
The data in the Center’s report shows only a small slice of the healthcare picture. In the face of an aging population and growing healthcare costs complicated by insurance payer restrictions, it is highly advisable for all of us stay healthy.
About the Author
Mike Pringle provides regular commentary for Red Scrubs and editorial content for Future Healthcare. He has over 20 years of nursing experience working both domestically and internationally. Mike has a Bachelor’s Degree in Nursing and a Masters Degree in Public Administration with a healthcare emphasis. He specializes in both Emergency and Critical Care Nursing. Mike has held positions ranging from department staff and Nurse Manager to Executive positions.
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