Acute care treats critical and unexpected medical problems in urgent care, surgical centers and emergency rooms. These environments handle minor sutures and splinting, X-rays, lab work and lifesaving interventions. However, acute care is not just a haven for serious illness. The disadvantages of acute care have implications that affect the entire population.
Misuse
According to a 2006 report in the St. Louis Business Journal, a study by the Integrated Health Network reported "37 percent of local emergency department visits are for primary care and other nonemergencies." For many, acute care has generated misconceptions in purpose. Patients sometimes use acute care due to their convenient, around-the-clock hours, or for second medical opinions. For those without insurance, health care laws have made acute care the solitary venue for treatment. Because patients are not denied therapy, regardless of ability to pay, the uninsured seek treatment for mild illness to chronic disease care.
Misuse of acute care has many flaws. Mismanaged care is much more likely without patient medical history records on file, and acute care doesn't encourage follow-up, as primary care does. Acute care misuse affects the community, utilizing staff and occupying rooms, and distracting from true emergencies.
Mistakes
Fast is not always best. A 1991 Harvard Medical study published in the New England Journal of Medicine examined 30,195 random hospital records, in which there were "1,133 patients with disabling injuries caused by medical treatment"--70 percent of which were "events occurring in the emergency room." Medical mistakes are seen in drug oversights, misdiagnosis and treatment errors.
In a 2000 publication by the British Medical Journal, Dr. Ross M. Wilson conducted a study finding "greater risk of death and a greater number of preventable adverse events" deriving from "the use of interventions thought to be potentially life saving." The study cites the causation to be "the use of part-time doctors not trained in emergency care; fluctuating demand for services, which results in uneven and sometimes abbreviated care" and "the limited time available to arrive at a definitive diagnosis."
Cost
As acute care centers seek payment for services, the result affects the community. According to the California Medical Association, doctors sought to resolve the issue with "balance billing," a concept denied in 2009 by the California Supreme Court. This aimed to protect doctors from when an "HMO submits a payment lower than the amount billed," and "doctors directly bill the patient for the difference between the bill submitted and the payment received." Not all states, however, have outlawed budget billing, leaving patients with large medical bills.
Acute care centers whose patient population has little or no insurance coverage suffer. They must operate on few funds to staff employees, maintain equipment and provide care, requiring facilities to raise rates for all patients. Even with these adjustments, many urgent care centers and hospitals have been forced into bankruptcy.
Education
Although patients often misdiagnose the need for acute care, little education is given on the topic. It's the medical community's responsibility to educate the public as to what can be treated at home, what requires more time to determine course, and what requires immediate attention. Insurance companies are beginning to invest in patient education, and many offer such services as advice lines for patients to call to ask about medical problems. There is hope that these changes will allow acute care to be devoted solely to efficient emergency medical care.
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