Good post from the DMCB summarizing a recent study on why patients use emergency rooms rather than primary care for medical treatment, despite the vastly higher costs of emergency room care:
64 hospitalized patients with low socioeconomic status were approached to participate in a "qualitative" research interview (here's one example of how it's done). The patients were selected because they had been hospitalized via the ER multiple times, were between the ages of 18-64 years, were uninsured or on Medicaid, lived in a poor ZIP-code region of the city...There are more interesting observations in the full blog post.
Two themes emerged:
1) Convenience/Access: Even if they have access to primary care, the emergency room and inpatient setting remains the more convenient option. That's because walk-in is available 24/7 and all testing as well as specialty care is available during a one-time visit. Zero dollar primary care co-pays don't make up for the hassle, time and expense of calling ahead for appointments, arranging transportation (even if vouchers through Medicaid are available) or being referred for separate testing as well as specialty consultation.
2) Technology: Based on personal experience with their primary care docs, the emergency rooms and hospitals were perceived to have more technically proficient providers who were better able to achieve the correct diagnosis and render the correct treatment in a timely fashion.