National Poll on Healthy Aging infographic on experiences with ER care

Costs, COVID-19 risk and wait times top older adults’ concerns about seeking emergency care, according to a University of Michigan National Poll on Healthy Aging.

Even before the pandemic, older adults had concerns about seeking emergency care due to costs, wait times and fears of ending up hospitalized. The risk of contracting the novel coronavirus in a hospital emergency department added to those worries, according to a national poll of adults aged 50 to 80 years. 

Each year, older adults make more than 40 million visits to emergency departments and often have complex needs that require greater care coordination and more follow-up services.

Fully 86% of the respondents cited the risk of COVID-19 as a consideration when deciding whether to seek emergency care, compared with 91% who mentioned wait times, 79% worried about out-of-pocket costs and 77% concerned about hospitalization.

The poll found one in three adults aged 60 to 80 have visited an emergency department in the past two years. When considering where to go for emergency care, 86% of older adults cited insurance coverage as an important factor, followed by the reputation of the emergency department (69%), location (68%) and recommendation by a healthcare provider (61%).

“Health insurers and policymakers are increasingly shifting costs to patients to deter overuse of care, including the emergency department; but these policies may be putting our most vulnerable patients at risk of avoiding care even when they have urgent concerns,” said Rachel Solnic, M.D., a University of Michigan Institute for Healthcare Policy and Innovation  national clinical scholar who worked on the poll.

More than 70% of the older adults who had an emergency department visit in the past two years went home rather than being admitted to the hospital, according to the poll. The majority said they were able to follow up to see their primary care physician (88%), fill prescriptions (97%), complete laboratory (70%) or radiology (66%) tests, or see a specialist (67%). Only 23% reported receiving the home care services recommended. 

The majority of older adults who visited an emergency department in the past two years “strongly agreed” that the healthcare provider explained their condition (68%) and care (69%) in a way they could understand. A majority (71%) also said they strongly agreed that the discharge plan of care was explained.

“These findings highlight important opportunities and a clear need for healthcare providers, insurers and health systems to better support older adults during and after medical emergencies to achieve higher-value, patient-centered acute care,” said Christina Cutter, M.D., a national clinician scholar at the University of Michigan’s Institute for Healthcare Policy and Innovation.

The poll, which drew from a national online sample of more than 2,000 adults aged 50 to 80, was supported by the AARP and Michigan Medicine, University of Michigan’s academic medical center.