Hospital emergency departments, as the name implies, are meant to be used for true emergencies. Unfortunately many trips to the ER are not life-threatening and are in fact both unnecessary and avoidable. A study published in 2013 found that only 29% of ER visits reviewed were actual emergency situations. Less than half of those visits that were not an emergency required medical attention but could have been treated in a primary care facility. One in four did not require immediate attention.
Low health literacy leads many patients to the ER when they could have received care at a less expensive setting – like at their doctor’s office or at a walk-in clinic. It’s also known that patients with low health literacy are more likely to make return visits to ERs within two weeks. Some barriers for patients with low literacy include:
- Not understanding or following doctor’s instructions for managing chronic conditions.
- Misunderstanding information they find about symptoms online.
- Not recognizing the importance of proper preventative care.
More recent research, presented at the Society for Academic Emergency Medicine Annual Meeting in Orlando, explored how low health literacy was related to preventable ER visits. The study looked at over 1,200 participants and a total of 4,444 ER visits. Over 10% of the visits were found to have been preventable.
Of the preventable visits, over 60% led to hospital admission. (The average cost of a hospital stay is estimated to be close to $10,000.) When researchers looked at the health literacy of the participants, those with lower health literacy were over twice as likely to have made a preventable ER visit. Having below an eighth-grade reading level was the definition used for low literacy.
The most common preventable conditions leading to ER visits included chronic obstructive pulmonary disease (COPD), urinary tract infections and long-term complications from diabetes.
While not surprising, the study illustrates that patients with low literacy are more likely to make preventable visits to ER and other emergency services. And increasing the literacy of patients can help dramatically decrease unnecessary healthcare costs.