A research article was published in the September issue of Health Affairs, that looked at how patients are using healthcare services for acute care. The study reviewed 354 million visits to healthcare institutions or healthcare providers for acute care  between 2001 and 2004. Twenty eight percent of the visits were handled by hospital emergency rooms, 22% were handled by general/family practitioners, 20% were seen by non-primary care specialists, 10% by general internists, and 7% by hospital outpatient departments.  The uninsured received more than half of their acute care in emergency departments and much of this occured on the weekends or weekday after hours. Two of the most frequent conditions seen were stomach pain and chest pain.

By definition, shouldn't "acute care" issues be seen in acute care? If you or your relative was having chest pain, would you send them to the primary care provider's office? I would hope not; you would call 911 and send them to the nearest emergency department for evaluation for an acute myocardial infarction.  If you or your relative were having severe abdominal pain, would you send them to the family practice office? No, of course not; you would send them to the nearest ED to be evaluated and have an ultrasound or CT scan done if appropriate.

I agree that our emergency departments are over taxed with patients coming in for complaints that could easily be treated in a primary care office or clinic. But, chest pain, severe stomach pain, fractures, and severe lacerations, just to name a few, need the attention of the experts who have the experience and the resources to treat those things that are clearly "acute care" issues.

Posted by Anne Dabrow Woods, MSN, RN, CRNP, ANP-BC