ER visits at Butler Memorial hospital decreased last year; illnesses more severe

| Saturday, March 29, 2014, 12:15 p.m.

Fewer people are using the emergency room at Butler Memorial Hospital, but when they do, they appear to be coming in sicker than ever.

Patient volume decreased 2 percent last year after a steady increase from 2010-12, said Crissy Emrick, director of emergency service at the hospital, but the severity of patient illness or injury increased, she said.

“I think sometimes patients are waiting, thinking that they're going to see if they can get better, and they just don't,” Emrick said. “So by the time they come in, they're pretty sick.”

Dr. Dave Rottinghaus, emergency department director at the hospital, said the ER saw about 48,000 patients in 2012. The next year, that number dipped below 47,000.

“But very sick people are still coming and coming even more,” he said. “The treat-and-release people are in smaller numbers.”

Hospital officials say they're not sure what caused the downward trend, but they have some ideas.

One could be the increasing amount of urgent-care and rapid-treatment centers that bridge the gap between primary doctors' offices and emergency rooms, Rottinghaus said. MedExpress Urgent Care, for example, opened its first office in Western Pennsylvania just 10 years ago but now has 35.

“It's not really a surprise that there's such a demand for patient-focused services,” said Kelly Sorice, spokeswoman for MedExpress. “It's accessible, affordable and convenient, and I think that's what most patients are looking for.”

Another factor in the decrease could be that health insurers are making ER visits more expensive, Emrick said.

“Some of the thoughts out there are related to people having a change in their insurance, having higher co-pays for emergency department care,” she said. “The emergency room is not a cheap place to receive care.”

The decrease translates to 10 to 15 fewer patients a day, Emrick said. Staffing levels remain the same, however. In emergency medicine, always expect the unexpected, Emrick said.

“We have to be able to staff for whatever may come through the door,” she said.

Though it's too early to say how many patients will come through the ER this year, Rottinghaus said the volume has begun to increase to 2012's level, and he expects that to continue.

“Since March 1, we're seeing an uptick in our daily volume, so it's going to sort of back to what it was,” Rottinghaus said. “Whether we'll be busier than last year, I don't know … but most people think ER department volume nationally will go up again.

“My best guess is that the population is not getting younger, and it's growing, especially the older population,” he said.

Rachel Farkas is a staff writer for Trib Total Media. She can be reached at 724-779-6902 or

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