Emergency Room vs Urgent Care for Severe Headaches

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Imagine you've had a migraine for three or more days with absolutely zero relief. You know you're at risk for migraine-induced stroke at this point, and it's obvious you need help ... but you can't reach your doctor because it's now a weekend or holiday. So your choices are: a visit to the emergency room, or to the urgent care center.

Which do you choose?

There are a variety of issues involved in deciding whether to go to the emergency room or the urgent care center.

The speed at which you'll receive care is one consideration, of course, but the quality of care you receive obviously is important, as well.

If you've had to make this decision before, you might be guided by whether your prior choice turned out to be a good one. But if not, some information gathered from people with migraines who have wrestled with this may help you.

ER, Urgent Care Use Not Unusual for Headaches

If you need urgent or emergency care due to a migraine or headache, you're certainly not alone. The Agency for Healthcare Research and Quality reports that about 7% of Americans with migraine use the emergency room or urgent care to treat their severe headache each year.

Headaches account for a relatively small percentage of all emergency room visits — just 2.2% — but that still amounts to some 2.1 million visits annually. Plenty of migraine sufferers report they need multiple visits to the ER each year.

In order to help people with severe migraines and headaches get care quickly, the National Headache Foundation asked members and non-members about their experiences in both emergency rooms and urgent care centers. Here's a sampling of what the survey found:

  • Urgent care was faster. Two-thirds of people responding to the survey waited for less than an hour at the urgent care center, while only one-third had that short a wait time in the emergency room.
  • Doctors and nurses at urgent care were nicer. About two-thirds reported that the medical staff members at urgent care centers were polite and respectful to them. Only 54% said the same of the clinicians staffing the ER.
  • Urgent care physicians explain things better. Some 58% said they got a clear explanation of their diagnosis at the urgent care center, compared to 38% in the emergency room. Urgent care physicians also provided better instructions on what to do if the headache or migraine returned, and were more likely to offer a home care plan.
  • Treatment at urgent care centers is more effective. About 53% said the treatment they received in urgent care was effective. Only about 36% who visited the ER said their treatment was effective.
  • Urgent care centers are more likely to offer a quiet spot. More than three-quarters of those who visited urgent care got a quiet area to stay in, compared with 60% who tried the emergency room.

Overall, half described their urgent care experience as "good" or "very good," compared with a little more than one-third of those who sought care at the emergency room.

The Bottom Line

This survey indicates you may get better care at an urgent care center than you would at a hospital emergency room. Of course, your mileage may vary — if you've had good experiences at your local ER, I wouldn't view this as a reason to switch.

One last thought: before you have to seek any kind of care on an urgent or emergency basis, take the time to review your health insurance policy to see which local options will be covered. You don't want to make a middle-of-the-night visit to knock out your migraine, only to receive an unexpected bill.

Sources:

Agency for Healthcare Research and Quality. Acute Migraine Treatment in Emergency Settings. Nov. 27, 2012. Accessed Dec. 3, 2015.

National Headache Foundation. "Emergency Room or Urgent Care Center: A Headache Sufferer's Dilemma." Press release dated July 5, 2006.

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