Extended practice hours may reduce emergency room visits
Keeping primary care practices open for more hours, particularly on nights and weekends, reduces patient visits to emergency departments for non-life threatening issues, according to a recent study published in PLOS Medicine.
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Researchers at the University of Manchester, England, determined that practices that extended their hours beyond the British standard of 8:30 a.m. to 6:30 p.m. had a 26.4 percent reduction in patients seeking emergency department visits for minor problems. The difference amounted to 10,933 fewer ER visits in a year. For every three additional primary care slots booked, one visit to the ER was avoided.
“Extending opening hours in primary care may be a useful addition to policies aiming to reduce pressures on hospital services, potentially reducing patient-initiated use of the emergency department for minor problems—but at a significant cost,” concluded William Whittaker and his colleagues, authors of the study.
While this study was conducted in England, its results may provide useful insights for the American healthcare system, where emergency room visits have long been targeted as an area for reducing the overall cost of healthcare. In 2013, a National Institute of Health study pegged the median cost of a visit at $1,233. If patients had the option of seeing their own physician or a medical professional in their physician’s office instead of visiting the emergency department, this would bring down the overall cost of the patient’s healthcare.
However, the question remains—are longer hours practical for most primary care practices? Nitin Damle, MD, MS, FACP, president of the American College of Physicians and a practicing internist, says they are indeed worth it.
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“We have had after-hours and Saturday morning hours for 15 years,” he says. “We find it helpful to patients, and it seems to decrease ER use modestly along with providing continuity of care.”
Turning to the familiar primary care practice instead of the emergency department provides patients with the benefit of professionals who already know their medical history.