The hospital’s Emergency Department is being abused by patients with non-urgent ailments that could be treated by a GP, it has been claimed.

And the practice is causing the cost of healthcare to increase because insurance companies are having to jack up their premiums to cover the cost of the “free” service.

According to the latest statistics, there were a combined 37,694 visits to the Emergency Department of King Edward VII Memorial Hospital and the Urgent Care Clinic in St David’s in 2013/14, compared to just 34,439 visits in 2009/10 — even though the Island’s population has shrunk in that time period.

The statistics also reveal that Emergency Room doctors are being asked to treat conditions such as sprains, asthma and cellulitis — a type of rash. The hospital’s Chief of Emergency and Hyperbaric Services, Edward Schultz, told The Royal Gazette that many patients were misusing the department.

“We certainly see patients on a regular basis who could have been treated in an office setting by their GP, paediatrician, or dentist,” Dr Schultz said.

“We also have a significant number of people — termed ‘superusers’ — who misuse the ED on a regular basis.

“The reasons that most people come to the ED range from acute severe pain from an illness or injury, to fear and lack of medical knowledge about symptoms that they are experiencing, to access issues — specifically lack of medical insurance — to those who simply don’t want to wait for an appointment with their physician, who may not be immediately available.

“It is important to remember that we are the only medical care available for most patients during evenings and nights after regular business hours, as well as on weekends and holidays. Many patients are actually sent to the Emergency Department by their GP or GP’s office staff if they have what sounds like a serious complaint over the telephone.

“Our top ten diagnosis from Emergency and the UCC for 2012-13 shows that sprains, open wounds and asthma are the top three diagnoses. Depending on diagnosis, a lot of these will be genuine emergencies. However, asthma is one of those conditions that — if managed correctly by the individual — often does not have to end up in an emergency situation. So the appropriate management of chronic diseases through community healthcare providers is also an important part of the equation.”

According to Dr Schultz, some patients are tempted to visit the ED because insurance companies will cover the full cost of a hospital visit, but only part-pay the cost of a GP’s consultation.

“An emergency visit costs more than a visit to a GP, although this is often a hidden cost to people who are insured,” Dr Schultz said.

“The hospital can only charge the standard hospital benefit [SHB] fee and no more, so insurance covers the cost completely. GPs can charge more and any excess over the SHB fee is covered by a co-pay by the patient at the time of the visit.

“This means using Emergency services instead of a GP drives up healthcare premiums. If we could reduce the inappropriate visits, and ensure that patients are seen by their GPs in those instances, this would help control healthcare costs overall for all people in Bermuda.”

The Bermuda Hospitals Board is now circulating a poster reminding patients that its emergency services are provided to treat urgent cases.

“Emergency services not free and should only be used if you need immediate medical attention,” the poster advises.

“Emergency staff will provide high quality healthcare to patients regardless of their ability to pay at the time of their visit. However, if you do not have insurance, you will receive a bill for the medical care provided.”

The poster advises that a single Emergency Department visit can cost up to $857 and does not include the cost of diagnostic tests or consultations with on-call specialists.

“The cost of accessing emergency services for minor conditions that could be treated by your family doctor results in higher healthcare costs. Using Emergency unnecessarily causes insurance premiums to rise, so in the end we all pay more,” the poster states.