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by pmiller2 3214 days ago
No, I don't think A&E is the same. "Emergency care" in the US is what emergency departments are for. I think this is the equivalent of A&E: go here if you are literally dying. "Urgent care" is for severe cases that don't have risk of imminent death: broken arm would be a great example. An ER will treat your broken arm, just probably not quickly. An urgent care facility is not equipped to handle anything life-threatening.

I'm not saying that the fact these things are separate implies it's worse than the European system, just different.

2 comments

In the UK there is the distinction between 999 (emergency services) and 111 for "urgent but not life threatening". 111 is staffed by nurses trained to triage and will escalate if necessary and get you an ambulance.

Similarly there tends to be walkin clinics if you don't think you can wait for your GP, but don't think it's something you should go to A&E/ER for. Most of them will not be equipped to handle surgery of any kind, but whatever decisions they do as part of triage will certainly be passed on if they believe you need to be sent to hospital.

I think the big difference is that in most European countries the default is to triage everywhere, unless you pay extra to go private, while Americans seem to be more used to triage being somehow mostly restricted to emergencies.

Triage sucks when you have a minor problem and want quick attention without paying extra for private care, but it's quite great when you have an urgent problem and don't have to wait behind people with much less pressing needs.

Well, some level of triage takes place anywhere you go in the US. If you're at the doctor's office or urgent care for chest pain, you're probably getting a ride to the ER. But, nobody's going to send you away from anywhere because you come in with a broken arm (assuming they're equipped to handle it) or the sniffles. It's just a matter of how long you will wait and how much you will pay.
There's a clue in the name - accident and emergency - that these departments handle urgent but non life threatening care too.

Really, it's a fucking stupid question. Of course Europe's socialised medicine will treat broken arms.

If the question is about the time taken to treat these problems: England is going to through a bit of a scandal at the moment about missed waiting time limits in A&E departments.

The maximum time from arriving at A&E through to either being treated and discharged, or admitted into the hospital for further treatment, is 4 hours. And that time limit must happen for 95% of patients.

And we're currently worried because at the moment it's over 90% (but less than 95%) of patients get treated and discharged or admitted to hospital within 4 hours.

We have the advantage of free or low cost primary care, so most people don't need to leave minor problems to fester until it's turned into a severe problem.

> Really, it's a fucking stupid question. Of course Europe's socialised medicine will treat broken arms.

Seriously, WTF? Where did I ever say broken arms don't get treated? Are you seeing a dumb American in my post because that's what you want to see?

The only thing I even wonder is where the appropriate place to go to get it treated would be. In the US, you can go to an emergency department or an urgent care facility. The urgent care facility is the most appropriate place: you will get seen promptly and they are equipped to handle it, and it will cost less than an ER visit (even after insurance, typically). You will get seen in the ER, but not quickly, and you will probably pay more.

"does the concept of urgent care exist outside the US?", someone else mentions A&E and you say that doesn't count because broken arms.

To answer your point: in England we have:

NHS Choices, a website that provides evidence based advice

NHS 111: a free telephone helpline where health care professionals offer advice, or arrange a call back from a doctor, or recommends a visit to an doctor (and arranged an out of hours doctor if needed), or recommends minor injuries or A&E (and arranges ambulance treatment if needed)

Pharmacy: all pharmacies offer health advice

GP surgeries have GPs but also nurses who can provide a range of treatment including minor surgeries

Minor Injury Units provide treatment for minor Injuries

Accident and Emergency provide treatment for life threatening and other severe accidents - bit they're also misused as walk in treatment centres for a range of mild conditions. Some injuries would mean you get transported to a different hospital after being stabilised -- severe chemical burns would be one example.

I've missed out midwife-led birth units, and all the mental health stuff.

For a broken arm you'd go to A&E. They have to treat it and discharge you within 4 hours. Or you could go to minor injuries, where you'd probably get treated within 4 hours. A&E would have better scanning imaging options.

All of these are free at the point of delivery.

They will also escalate you pretty quickly of you go to a Minor Injury Unit with something that turns out to be reasonably serious (see comment elsewhere)!
You're using a bunch of US-specific names and I don't know how they translate. But of course anywhere will have a variety of facilities appropriate to different severity issues; the specifics vary from country to country. And of course if you go to the wrong place you might end up waiting longer, but will still be treated or at worst referred to somewhere that can treat you appropriately, and anything urgent will be treated appropriately quickly.