On the complex, divisive issue of health care, people tend to agree about one thing: It’s important to reduce the number of expensive emergency room visits that can be handled more economically at a doctor’s office.
But a new study from Perelman School of Medicine at the University of Pennsylvania suggests that perception needs to be re-evaluated.
The study concludes that poor patients use emergency and hospital care more than primary care not because they don’t understand their choices but because they believe hospital care is more affordable, more convenient and of better quality. The study was published in the July issue of “Health Affairs.”
Researchers interviewed patients who were either uninsured or on Medicaid and learned: Those patients tend to trust the hospitals more for quality care, and they are daunted by long wait times and less accessibility to outpatient caregivers.
And while the direct costs of an emergency department visit and a physician office visit were similar, some patients found outpatient care was ultimately costlier because it required extra time and visits as recommended by the caregiver.
So hospitals hoping to reduce costly hospital readmissions by improving the quality of hospital care might find their efforts actually attract even more low-income patients.
Any attempt to reduce inappropriate hospital visits should consider how to make outpatient services more appealing to poor patients.
Common sense suggests that anyone — with insurance or without — is unlikely to choose health care that he thinks is more difficult to obtain and inferior in quality.
And this study suggests we should beware any promises, no matter how alluring, to reduce the cost of health care.
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