Emergency room vs. urgent care
Planning ahead can help you make the right decisions when disaster strikes.
More than 100 million Americans go to the emergency room every year. While most of us visit the ER only for true emergencies, according to the Centers for Disease Control and Prevention, the most common reasons people visit the ER include stomach and abdominal pain, chest pain, fever, headache, and back pain. Some of these symptoms (like chest pain) could indicate serious conditions (such as a heart attack). But many do not.
A visit to the emergency room can cost up to five times more than a visit to an urgent-care center. Emergency-room treatment for non-emergency medical conditions is a major contributor to the rising cost of health care. It also ties up ER staff members, who spend valuable time treating non-critical cases, such as skin rashes and ear infections, rather than treating life-threatening conditions.
For many injuries and illnesses, an urgent-care clinic is the more appropriate place to go. Not only will you see trained nurses and doctors, you'll often be seen more quickly than in the ER. Here is a general guide to indicate when to go to an emergency room and when an urgent-care visit might be a better option.
- Bleeding that doesn't stop after 10 minutes of direct pressure
- Signs of a heart attack, such as chest pains that last more than two minutes
- Signs of stroke, such as numbness of the face, arm, and leg on one side of the body, sudden loss of vision, or loss of speech
- Severe shortness of breath or sudden dizziness
- Major injuries such as broken bones, partial or total amputation of a limb, or trauma to the head
- Coughing up or vomiting blood
- Suicidal feelings
- Cuts or wounds where bleeding is controlled
- Sprains, strains, or bruises
- Mild or moderate asthma attacks
- Infections of the urinary tract, ear, or upper respiratory system.
- Flu-like symptoms, such as sore throat, fever, coughing and congestion
- Mild or moderate stomach pains or diarrhea
- Rashes, insect bites, or sunburns
The best course of action is to make a plan in advance so you know where to go, when. Talk to your primary care provider about the emergency rooms or urgent-care facilities near you. Check your coverage to see which facilities are in your network, and whether the amount of ER coverage differs at in-network and out-of-network hospitals. Use Provider Search to find ER and urgent-care facilities in your network.
If you're not sure whether or not to go to the ER, call your primary care provider. Even if it's after hours, there may be a nurse or on-call doctor you can talk to. Your coverage may also provide you with access to an advice nurse. If you're not sure, call the customer service number on the back of your membership card to find out.
For those who don't have a primary care provider, urgent care facilities can be a great resource. If you've just moved to a new area and you sprain your ankle, urgent-care services can see you right away. You don't have to spend time trying to find a provider who is accepting new patients. Plus, most urgent-care facilities are open in the evenings and on weekends. They can even help you refill a prescription.
Many people end up in the ER because they don't know what else to do. By having a plan and thinking ahead, you can make smart choices that are good not only for your health, but your budget as well.