Where Americans Get Acute Care: Increasingly, Its Not At Their Doctors Office, Stephen R. Pitts, Emily R. Carrier, Eugene C. Rich and Arthur L. Kellermann. Health Affairs, 29, no. 9 (2010): 1620-1629 doi: 10.1377/hlthaff.2009.1026
“Historically, general practitioners provided first-contact care in the United States. Today, however, only 42 percent of the 354 million annual visits for acute caretreatment for newly arising health problemsare made to patients personal physicians. The rest are made to emergency departments (28 percent), specialists (20 percent), or outpatient departments (7 percent). Although fewer than 5 percent of doctors are emergency physicians, they handle a quarter of all acute care encounters and more than half of such visits by the uninsured. Health reform provisions in the Patient Protection and Affordable Care Act that advance patient-centered medical homes and accountable care organizations are intended to improve access to acute care. The challenge for reform will be to succeed in the current, complex acute care landscape.”
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