hospital

Your Health

Urgent care or ER? The right answer may surprise you

Dec 07 2015
Top

If you’re suddenly sick or injured, your first thought may be to head to the emergency room. But depending on your medical issue, the ER may not be your best choice. Urgent care facilities are cropping up everywhere, offering more people a more convenient way to get quick care. And if you go to one that is in your health plan’s network, your visit may cost you a whole lot less.

Aetna estimates that more than 50 percent of ER visits are avoidable – meaning care could have been provided in an urgent care facility (or even a physician’s office) at a lower cost. Those costs can really add up when you look at it from a health system perspective. An in-network urgent care visit can cost as little as 20 percent of a visit to an ER, according to Aetna average claims costs.

How does a person know when to choose urgent care? “Often, a person might need immediate medical attention but not necessarily at the level of a hospital emergency room,” said Scott Spradlin, M.D., chief medical officer for Aetna’s Local & Regional Business unit.

Remember: If you are experiencing symptoms such as chest pain, difficulty breathing, bad bleeding or other life-threatening issues – go straight to the closest ER.

If you think you have something less immediately life-threatening like a possible broken arm or an ankle sprain, going to an urgent care facility that is in your health plan’s network could offer two important benefits to you: time and money. While you may be in a lot of pain with a sprained ankle, emergency room staff have to constantly prioritize who gets seen when, based on who has the most serious medical crisis. The average treatment times in an ER can be considerably longer than in an urgent care center, according to the Urgent Care Association of America. Urgent care centers fill up too, but the life-and-death emergencies are not as likely to be coming through their doors. Urgent care centers usually offer very convenient hours, with many open seven days a week with extended evening, weekend and holiday hours. And you don’t have to look far to find one: There are more than 6,900 urgent care centers across the country, and that number is growing constantly.

Below are some common medical issues that urgent care centers are well-equipped to handle:

  • Headache
  • Fracture
  • Infections
  • Flu
  • Allergies, bronchitis or sinusitis
  • Cuts and minor lacerations
  • Burns and rashes
  • Urinary tract infection
  • Hypertension/high blood pressure
  • Nausea

The list of other common ailments and issues urgent care facilities can treat is extensive, too:  sports injuries, whiplash, gastritis, falls (from less than seven feet), lumbago (lower back pain) and more. Urgent care centers can also provide non-urgent care, such as vaccinations and removal of skin lesions.

If you’re faced with an urgent, but non-life-threatening condition, it’s best to call your own primary care doctor first.  You can discuss your best treatment options if your doctor can’t see you soon enough. Chances are, an urgent care facility may be the right choice for many common medical issues like those listed above. Just make sure you go to one that’s in your health plan to save yourself some money.

Editor’s note: Need to know where the nearest urgent care facility? There are lots of great online tools available. iTriage, for example, lets you use your computer or mobile device to locate the nearest urgent care or walk-in clinic as well as other types of providers. And if you’re an Aetna member, you can simply sign in to Aetna.com, click “Find a doctor” and then select “Urgent Care Facilities” for a list of available locations.