ER vs. Urgent Care

When family members get sick, what’s your family’s first line of defense? In some situations it’s easy to know what to do: a call to the doctor’s office when your child is battling a common cold or a trip to the Urgent Care & ER sign emergency room (ER) after a concussion results in a headache or vomiting. But many times, depending on the medical need and condition, it’s harder to determine the appropriate call to make when immediate care is needed—especially after hours.

Extra bills you weren’t expecting

Making the right choice between an ER and an Urgent Care visit helps ensure you receive the care you need in the most appropriate setting.

Man upset reading a bill
From the ER, you may receive an additional bill from a specialist

It can also make a big impact on the cost of your care. Over the past decade, costs for ER visits have jumped 176%¹, with the average visit totaling $1,389. ER visits also increase your chances of receiving a “surprise bill” from a specialist, a recent study found², adding an additional $630 on average to the cost of care. To compare, the average cost of an urgent care visit is $150³.

With 14.7% more patients enrolling in high deductible health plans (HDHP) than in past years and debt related to medical costs cited as one of the primary reasons for bankruptcy in America, making the right choice between Urgent Care or the ER can help families save big on the cost of care.

Which should you choose?

Our experience at Holston Medical Group points to a few important things to consider to ensure you’re being a smart healthcare consumer—making the right decisions not only with cost, but also considering the severity of the condition. How do you decide when it’s appropriate to head to the ER vs. when Urgent Care is more likely needed?

Average cost of ER visit
$1,389
ER staff

When to go to Urgent Care

Urgent Care is the bridge between primary care and the ER. It’s a fast and convenient option not only for treatment of minor injuries, but also sudden illnesses that are not life-threatening, such as upper respiratory infections, sinus infections, earaches, persistent diarrhea, superficial wounds, and sprained joints. Typically, patients receive care for minor illnesses and conditions much faster in an Urgent Care clinic than in the ER. That’s because patients in the ER are triaged according to the severity of their condition.

Average cost of Urgent Care visit
$150
Urgent Care staff

One example and a good rule of thumb: adults with a fever of 102 or lower also may seek treatment in Urgent Care. The exception: If a high fever is accompanied by lethargy, irritability, discomfort, lack of response to medication, or has lasted more than three days, go to the ER.

When to go to the ER

man with chest pain
For chest pain lasting two minutes or more, go to the ER

Are you experiencing wheezing, shortness of breath, or difficulty breathing? Do you have an infant with a fever of 100.4 or higher? Do you feel dizzy or numb on one side, or are you experiencing chest pain or abdominal pain that lasts two minutes or more? Head to the ER. These symptoms can be signs of serious illness and should be treated right away. Deep cuts and gashes that require more than a few stitches also are best treated in an ER setting.

When in doubt, call your physician

If the illness or injury doesn’t appear to be life-threatening, a call to your physician’s office—even after hours—can help you make the right decision in minutes.

Questions? Be sure to make this a topic of conversation at your next primary care visit, or contact Holston Medical Group at 1-877-HMG-1213.

¹Alltucker, K., “‘Really astonishing’: Average cost of hospital ER visit surges 176% in a decade, report says,” USA Today, June 4, 2019, https://www.usatoday.com/story/news/health/2019/06/04/hospital-billing-code-changes-help-explain-176-surge-er-costs/1336321001/.
²Lagasse, J., “Surprise medical bills in ER and inpatient settings are soaring, JAMA finds,” Healthcare Finance, Aug. 13, 2019, https://www.healthcarefinancenews.com/node/139058.
³Fay, B., “Emergency Rooms vs. Urgent Care Centers” Debt.org, Sep 12, 2019, https://www.debt.org/medical/emergency-room-urgent-care-costs/.