Oftentimes workers resort to emergency departments (EDs) to receive their initial medical services after a work-related injury. For some injuries, workers may be more likely to use ED services rather than going to physician offices or urgent care clinics—which are less costly alternatives to ED services. For instance, for patients with sprains and strains there may be a greater scope of substitution between ED and non-ED options than for injuries like lacerations or severe fractures, where immediate ED services may be more appropriate. State regulations and local practices may also have a role in shaping the decision of workers to use ED services. Not least, the COVID-19 pandemic caused many patients to delay or avoid urgent medical care.

This FlashReport provides fresh insights into how the use of EDs versus physician offices for initial medical services varied across states in workers’ compensation in recent years. It also explores some of the factors explaining the observed interstate variation in the use of EDs by workers with various injury types and how COVID-19 impacted the use of EDs as the source of initial medical services.

The study tracked evaluation and management and ED utilization patterns for workers injured in 28 states: Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. These study states represent 79 percent of the workers’ compensation benefits paid in the United States. 

Initial Medical Treatment at Emergency Department or Physician Office: Interstate Comparisons and Early COVID-19 Impact—A WCRI FlashReport. Olesya Fomenko. December 2022. FR-22-03.

Copyright: WCRI