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When It Comes to Senior Health Care, Urgent Care Oftentimes Better Option Than The Emergency Room

By Daniel M. Rothberg, MD | Emergency Medicine/Urgent Care

For 74-year-old Ellen, the misstep that caused her to turn her ankle while carrying a basket of clothes downstairs to the laundry room was not as significant as her misstep in seeking treatment for this non-life-threatening injury at a local hospital emergency department rather than at a nearby urgent care center.

Ellen insisted her husband drive her to the hospital. She was familiar with the facility and had used the emergency department before. She certainly could not wait until Monday to call her physician’s office; the pain in her ankle was too great. She could hardly put weight on it. The ankle might be fractured, she thought.

After a three-hour wait, during which time her husband suggested they leave to find treatment elsewhere, Ellen was seen by an emergency medicine physician. The ankle was X-rayed, but no fracture was found. Ellen had sustained a grade II sprain, so the doctor immobilized the ankle with a compression wrap, and told Ellen to keep her foot elevated, take ibuprofen for pain and contact her primary care doctor for follow-up.

Three weeks afterwards, the ankle had healed substantially, but the financial pain had just begun. The hospital charge for treating her sprained ankle exceeded $1,000. Although her Medicare plan covered much of the cost, Ellen was still responsible for payment of a portion of the bill.

Had Ellen opted to visit her area’s urgent care center, which is open on weekends, her wait would have likely been under an hour, her treatment comparable to what she received at the hospital, and the cost as much as 80 percent less.

In an era of increasingly long waits for physician office appointments, overcrowded hospital emergency departments and rising health care costs, urgent care centers have developed as convenient, cost-effective, alternative sites for the treatment of non-serious, acute illnesses and minor injuries that require immediate attention, such as:

  • Sprains and fractures
  • Upper respiratory problems like sinus infections, flu-like symptoms and colds
  • Shallow lacerations and cuts
  • Minor eye, ear, nose and throat problems
  • Animal bites and limited reactions to insect bites and stings
  • Minor burns that may blister

In 2013, the Center for Studying Health System Change for the National Institute for Health Care Reform released a report indicating that urgent care centers are filling an “access gap” by providing walk-in care, particularly during evening and weekend hours, for patients who either do not have a primary care physician or who are unable to obtain ready appointments with their own doctor. Most urgent care centers offer X-rays, laboratory tests and other diagnostic services.

National surveys show that older adults are contributing to the patient strain on hospital emergency departments at increasingly higher rates by using them for non-life-threatening problems. In fact, a Rand Corporation study published in the journal Health Affairs in 2010 suggested that nearly 30 percent of all visits to an emergency department could be readily treated at an urgent care center or retail clinic.

Of course, seeking treatment at a hospital emergency facility is imperative if a patient is experiencing potentially life-threatening symptoms. These include:

  • Persistent chest pain and shortness of breath.
  • Difficulty speaking or understanding speech, loss of balance, sudden vision changes, weakness or paralysis, particularly on one side of the face or body
  • Altered mental status
  • Large, open wounds or wounds that will not stop bleeding
  • Serious head and fall-related injuries
  • Severe headache
  • Deep burns or burns caused by electricity or chemicals
  • Severe, persistent vomiting or diarrhea
  • Persistently high fever with rash
  • Serious allergic reactions

Most importantly, seniors can take charge of their own health by preparing for emergencies. At CareMount Medical, we suggest that you:

  • Keep a list of all your medications, both those prescribed by your doctor and any over-the-counter drugs and vitamin supplements. The information should detail how much of each medication you take and how often you take it.
  • Note your allergies, including allergies to medications.
  • Know the dates of any past procedures or surgeries.

Such information will prove helpful to the provider who is providing you with immediate or emergent care, because he or she will need to know your medical history.