How to get the right care, at the right place, at the right time

Emergency room or urgent care? Here’s how to make the right decision.
Feb 5, 2019 · Christina Vanvuren
Soccer players supporting an injured player

You fall and break your hip. Do you go to urgent care or the emergency room? What if you burn yourself while cooking? How can you be certain you’re making the best choice? With rising healthcare costs and an increasingly complex healthcare system, more Californians than ever are on high alert about where they get care.

It’s important to know when you should go to the ER or go to an urgent care center, and what you can expect at each. When you understand which illnesses and injuries are considered emergencies, you can make more informed choices about your care. 
 

When should I go to the ER?

If you have a serious medical emergency that could be life-threatening or cause loss of limbs or vision, call 911 and go to the ER right away. If you have any doubts about whether you should drive yourself or call the paramedics, always call 911. 

Commonly treated injuries and illnesses at emergency rooms include:

  • Any life-threatening or disabling condition
  • Injury, with loss of consciousness or fainting
  • Uncontrolled bleeding
  • Sudden numbness of limbs or face, difficulty speaking
  • Broken bones that restrict movement
  • Severe shortness of breath or difficulty breathing
  • Sudden, severe chest pain or pressure
  • Major injuries, vehicle accidents, stab wounds
  • Serious burns
  • Poisoning
  • Sudden, severe abdominal pain
  • Vomiting blood
  • Drug overdose
     
When should I go to urgent care?

If your symptoms aren’t life-threatening – or if you can’t get an appointment quickly enough with your primary care physician (PCP) – urgent care could be a good choice. Urgent care centers are walk-in clinics that can treat non-life-threatening medical problems. Some urgent care centers offer preventive care services, like school physicals and flu shots, though it is better to see your PCP for those needs.

If you are a Blue Shield member, you can register online or log in to your account to find your PCP contact information, other specialists, or the urgent care center closest to your home. You can also download the mobile app to have this information on the go. 

Commonly treated injuries and illnesses at urgent care centers include:

  • Cough, sore throat, respiratory infections
  • Earaches
  • Back pain, body aches
  • Burning with urination
  • Colds, sinus infections
  • Allergies
  • Eye irritation, swelling, or pain
  • Sprains, muscle strains
  • Rashes, minor cuts, scrapes
  • Nausea, vomiting, diarrhea
  • Animal bites

     
Why it’s better to go to urgent care for non-emergencies

Urgent care centers offer two major benefits:

  1. Urgent care costs less money.  A 2013 study by Truven Health Analytics found that 71% of ER visits were unnecessary or could have been avoided. Not only does misuse of the ER cost more for individual patients, but it also impacts the healthcare system. The cost of any medical visit can vary depending on whether you have health insurance, whether you’ve met your deductible, and what you’re being treated for. Regardless of your insurance, urgent care usually costs less.

    According to Solv Health, a platform that allows patients to book same-day urgent care appointments online, the average cost of an urgent care visit is between $100 and $200. Emergency department visits can range from twice that to tens of thousands of dollars, depending on what you’re treated for. Debt.org explains, “If you had to use an ambulance service to get to the emergency room, you could be charged anywhere from $25 to as much as $1,200, depending on whether you have insurance and what type of plan you have.”
     
  2. Urgent care has shorter wait times. When you go to the ER for an illness or injury that could have been treated at urgent care, it causes longer wait times and a spike in cost for individuals and the healthcare system. Hospitals prioritize patients based on the urgency of their illness or injury. So, if you go to an ER for a medical issue that is not a true emergency, be prepared to wait.

    A 2010 report from the American College of Emergency Physicians and Press Ganey showed that the average wait time at a California ER is about 4 hours and 34 minutes. At urgent care, you can generally expect to wait less than an hour. 

While the emergency room will always play an important role in delivering care to patients, urgent care centers give you access to similar care for far less money and time. Californians now have access to hundreds of urgent care centers across the state, which makes getting the care you need easier than ever.