Rationally Choosing the Emergency Department over Primary Care for Non-Urgent Conditions: Valuing Consumer Benefits

Grant: #73051

Grantee Institution: University of Colorado Denver

Principal Investigator: Anne Libby, Ph.D.

Grant Period: October 1, 2015 – December 31, 2017

Budget: $399,681

Project Aim: Provide a deeper understanding of Medicaid enrollees’ valuation of emergency department care and its alternatives to inform efforts to optimize health care delivery, provide patient-centered, high-quality care, and lower health care costs.

Project Description:

Use of the emergency department (ED) for non-urgent conditions has been consistently higher than expected or desired among payers and providers.  While ED overuse may reflect barriers to accessing primary care, another hypothesis posits that ED use is a systematic choice by consumers that reflects their perceptions and values for health care services and the constraints on their time, finances, and other resources.  In order to examine Medicaid enrollees’ valuation of ED care and its alternatives, the researchers interviewed and surveyed adult Medicaid enrollees seeking care for non-urgent conditions at a Colorado ED.  The researchers measured how patients perceive and value health care services in four key domains: 1) costs to the patient for ED and primary care services; 2) value of health services; 3) quality of care; and 4) socio-cultural perceptions of care.  The goal of this project was to provide a deeper understanding of patients’ preferences and valuations of care that helps inform efforts to optimize health care delivery, provide patient-centered, high-quality care, and lower health care costs.

This project was funded as part of the Robert Wood Johnson Foundation’s solicitation “Optimizing Value in Health Care: Consumer-focused Trends from the Field,” which supported studies that addressed consumer perceptions of value in the new and emerging health care landscape.