Monday, May 26, 2014

Urgent Care vs. Emergency Department

How does should a consumer decide if they should go to an ED or an urgent care facility?
This on the surface looks obvious but as usual the “Devil is in the Details.”
Chief complaints, severity of pain, ease of access, time of day or night, insurance mandates, technological needs (cat scan etc.) and the ability of the consumer through the internet to predict complexity of work-up are all factors to consider when deciding.
Emergency Department:
Consider these factors when deciding if an ED visit is necessary:
  •  If there is high complexity of care needed
  • If immediate treatment is needed, what facility will be able to do so
  •  If extensive testing is needed, what facility will be able to do so
  •  Possible admission to hospital
  • Emergent need of specialists
The follow chief complaints are better served initially at an ED:
  • Chest Pain
  • Shortness of Breath
  • Severe Abdominal/Pelvic Pain
  • Pregnancy issues
  • Severe Headaches
  •  Severe back pain with numbness
  •  Tingling
  •  Urinating problems
  • Multiple injuries
  • Head injury with loss of consciousness
  •  Deep lacerations
  •  Fractures with deformity
  •  Children< 3 months old
  •  Elderly patients with multiple medical issues
  • Psychiatry issues

Urgent Care:
Research capability of the urgent care of your choice:
  • Hours
  • X-ray
  • Relationships with local institutions and specialists
Most other complaints can be seen by the urgent care and then referred to a specialist or a hospital for further care.  The urgent care can treat most illnesses that do not need extensive evaluation. The smart consumer will develop a relationship with their local urgent care and call for advice.

A few more things to keep in mind for the consumer: 
  • A significant number of cases are seen first in an UC, and later in an ED. These fall into two categories: a) those that are transferred or referred to the ED for more complete evaluation, and b) those that do not recover or progress as expected and need a more intense workup.
  • Many EDs have, in effect, UCs within their ED environment.  These are usually called, when so embedded, “Fast Track” units.  But sometimes the term UC may be used.  The problem here is that because many EDs are quite full, embedded FT or UC units may receive overflow from the main ED. This impedes the ability of the FT to flow as fast as the off-campus UC, in which hospital limitations are not present. 
  • It is of value to inquire of your personal physician regarding his experience with any local ED or UC, since he may be called if you happen to appear in either site.  At times, he/she may be able to recommend the best approach for various circumstances that may arise for you or your family.

1 comment:

  1. I am thankful to you for telling the importance of both urgent care and emergency department. I have never heard these points before. These all points are new and informative for me.