Report: Half of local ER visits could have been avoided
In 2011, Forsyth County residents made approximately 159,000 emergency department visits, almost one visit for every two residents. About half of these visits could have been treated or prevented in a primary care setting, according to a Forsyth Futures study completed this month.
The study found that in 2012, the most recent year of data available, about 24 percent of adult residents and 8 percent of residents under 19 did not have access to any kind of health insurance, and the percentage of adults without health insurance increased steadily from 2008 to 2012. The study also found that the cost of care and medications is a major barrier to health care access, that Forsyth County residents encounter, and that cost was a barrier to some insured residents as well. Transportation, difficulty navigating a complex health care system, and not being able to take time off of work to attend doctors’ appointments were also barriers to accessing health care described by local residents and community experts.
About half of emergency department visits made by Forsyth County residents in 2011 could have been treated or prevented in a primary care setting. This type of emergency department use does not necessarily reflect an abuse of the system, according to the report. Conversations with local residents and experts found that some residents use the emergency department for conditions that could be treated elsewhere because they perceive their condition to be an emergency; they are unaware of or unable to connect to other community resources; they cannot afford health care services; they could not take time off work to see a primary care provider during the work day; or they delay seeking care until their health problem becomes an emergency.
“The use of the emergency department for conditions that could have been treated or prevented in a primary care setting could indicate that residents are facing barriers accessing primary care resources. Emergency department care tends to be more expensive than care delivered in a primary care setting, and residents who routinely use the emergency department instead of a primary care practice may not be getting the kind of medical supervision and consistent care they need to manage chronic conditions and improve their health,” said Elizabeth Perkins, Forsyth Futures Research Analyst.
Forsyth Futures found that residents living in some areas or pursuing certain types of care face more barriers than others. There is a designated Health Professional Shortage Area within parts of Winston-Salem, and this area also has a high percentage of Medicaid beneficiaries and persons without access to a vehicle. Forsyth county residents and professionals also reported that some specialty care, such as dental and behavioral health services, can be difficult to access, especially for residents who are uninsured or publicly insured.
Forsyth County has at least 95 programs, housed in 48 different organizations to help residents access health care. In addition, there are at least 15 community clinics that provide care to uninsured and underinsured residents. These community clinics serve some of the county’s sickest patients and experience a variety of challenges to providing this care. Some of the challenges reported by community clinic providers included coordinating patient care across multiple organizations, the complexity of care that their patients required, the scope of services they were able to provide, and the volume of patients who need assistance.
Established in 2006, Forsyth Futures is a non-profit, community research organization that studies Forsyth County data to track trends in the well-being of our community.
