Across southwestern Pennsylvania, emergency rooms have spent the last five years expanding, improving and, in many cases, rebooting from scratch. It is, experts say, an unprecedented building spree, mirrored nationally and brought on by a variety of factors. But while hospitals say the construction was driven by a need to upgrade aging facilities, insurers and industry watchdogs worry about ER arms races, mainly because ER care for routine injuries is often four times the cost of the same care when it's dispensed at a doctor's office or urgent care clinic.
