More than half of America’s 354 million annual acute-care visits – for fevers, stomach aches or coughs – typically take place in a hospital emergency room rather than in a primary-care physician’s office. This statistic was revealed in a study of systemic waste published in the journal Health Affairs. According to the study’s authors, their findings underscore a valid question about the healthcare reform law – how can a system that is already overwhelmed provide care to an additional 32 million newly insured patients?

The study, led by Dr. Stephen R. Pitts, an associate professor of emergency medicine at Emory University, examined acute-care visit records from 2001 to 2004 and found that 28 percent were to the emergency room.  This was particularly true for weekend and after-hours visits.  More than 50 percent of acute-care visits by patients who lacked health insurance were to emergency rooms, which are required by federal law to threat anyone with a serious condition.  This places a heavy financial burden on hospitals, which are compelled to provide basic care in what is admittedly an expensive environment.  Often, there is little or no follow-up to determine progress or secure follow-up care.

“More and more patients regard the emergency room as an acceptable or even proper place to go when they get sick,” according to Dr. Pitts.  “And the reality is that the E.R. is frequently the only option.  Too often, patients can’t get the care they need, when they need it, from their family doctor.”  The Affordable Care and Patient Protection Act is anticipated to boost primary care by increasing reimbursements for physicians, attracting students to the field with incentives; expanding community health facilities; and encouraging accountable-care organizations and medical homes.  “If history is any guide, things might not go as planned,” Dr. Pitts wrote.  “If primary care lags behind rising demand, patients will seek care elsewhere.”