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ACEP Critical of CDC Report on ED Use

Cheryl Clark, for HealthLeaders Media, May 20, 2010

In its continuing disagreement with the Obama Administration, the American College of Emergency Physicians yesterday called on the CDC to release a comprehensive report on emergency room usage, as it usually does, saying that its latest document "is much less comprehensive than previous annual reports."

"It is critical to know, for example, how many patients use the ER, how many are admitted to the hospital from the ER, and the top reasons that people seek emergency care," said Angela Gardner, MD, ACEP president.

"This new format makes it difficult to compare reports from previous years."

ACEP has taken issue with Health and Human Services Secretary Kathleen Sebelius and other Obama officials for their suggestions that emergency room use would fall off greatly if people just had health insurance. Also at issue is the administration's contention that large numbers of people who come to an ED are not urgent and could be treated by their primary care providers if healthcare reform paid primary care doctors more, encouraging more medical students to choose general practice.

"The facts don't bear that out," past ACEP president Nick Jouriles said in an interview last year.

The fault with Sebelius' logic, he and other ACEP representatives say, is that people will still use the emergency room because they won't be able to get an appointment with a primary care doctor when they need one. Also, most of the patients who come to the emergency do, in fact, have symptoms that need prompt evaluation.

In yesterday's statement, Gardner criticized the Centers for Disease Control and Prevention's 2007 report saying it contains "few data points ... that confirm what emergency physicians know from experience: Emergency visits remain at record high levels, and the rate of non-urgent visits is declining.

"Only 10% of emergency visits by people under age 65 were considered non-urgent. Furthermore, uninsured patients are no more likely to be triaged as non-urgent than patients with health insurance," she said.

Gardner added that "it's important to note the report finds that having a usual source of medical care, such as a primary care provider, does not affect the number of times people under age 65 visit the emergency department. It also finds that people over age 65 with a usual source of care are actually more likely to seek emergency care.

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