David Goldman / AP

A new study from researchers at the University of California at San Francisco has found that only a tiny fraction (3.3%) of emergency room visits are considered "avoidable" — meaning people went home and didn't need any procedures, tests or medications. The results were based on seven years of federal ER visit data.

Why it matters: Some states and health insurers are charging people higher out-of-pocket costs or refusing to pay claims if they determine after the fact that an ER visit was unnecessary. The goal is to save money and route people to lower-cost settings like urgent care centers. But the study suggests that most ER visits are valid, and that retrospectively penalizing patients could complicate the issue.

The details: ER doctors conducted this study and others. But they focused on objective insurance claims and federal data, giving credence to the methodology. Toothaches, back pain and headaches were the most common forms of preventable ER visits. But there's more to the study:

  • The definition of "avoidable" is what splits most parties. And determining a visit is avoidable after it happens may ignore symptoms that appear to be urgent at the time.
  • It's difficult for an average person to know what an emergency is. And if it's after hours, most things seem like an emergency.
  • Investing more in preventive measures like dental or mental health (or dealing with exorbitant provider prices) could alleviate many concerns.

Outside voice: "Sore throats and runny noses are not bogging down our system," said Laura Burke, an emergency room physician and researcher at Beth Israel Deaconess Medical Center in Boston, who was not involved in the latest study. She works at several emergency sites and believes few visits are truly preventable. But she said she also tries to understand why someone would come to the ER if the problem doesn't seem urgent.

"Usually it's a reason that makes sense," Burke said. "Maybe they work two jobs, and 2 a.m. was the only time they could come."

Go deeper

Trump signs bill to prevent government shutdown

Senate Majority Leader Mitch McConnel and President Trump arrives at the U.S. Capitol in March. Photo: Samuel Corum/Getty Images

President Trump signed a bill to extend current levels of government funding after funding expired briefly, White House spokesperson Judd Deere confirmed early Thursday.

Why it matters: The move averts a government shutdown before the Nov. 3 election. The Senate on Wednesday passed the legislation to fund the federal government through Dec. 11, by a vote of 84-10.

Of note: While the previous measure lapse before Trump signed the bill, the Office of Management and Budget had instructed federal agencies "to not engage in orderly shutdown activities," a senior administration official told the New York Times, because of the OMB was confident the president would sign the measure on Thursday.

Editor's note: This is a developing news story. Please check back for updates.

Updated 37 mins ago - Science

In photos: Deadly wildfires devastate California's wine country

The Shady Fire ravages a home as it approaches Santa Rosa in Napa County, California, on Sept. 28. The blaze is part of the massive Glass Fire Complex, which has razed over 51,620 acres at 2% containment. Photo: Samuel Corum/Agence France-Presse/AFP via Getty Images

More than 1700 firefighters are battling 26 major blazes across California, including in the heart of the wine country, where one mega-blaze claimed the lives of three people and forced thousands of others to evacuate this week.

The big picture: More than 8,100 wildfires have burned across a record 39 million-plus acres, killing 29 people and razing almost 7,900 structures in California this year, per Cal Fire. Just like the deadly blazes of 2017, the wine country has become a wildfires epicenter. Gov. Gavin Newsom has declared a state of emergency in Napa, Sonoma, and Shasta counties.

Updated 1 hour ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 12:30 a.m. ET: 33,880,896 — Total deaths: 1,012,964 — Total recoveries: 23,551,663Map.
  2. U.S.: Total confirmed cases as of 12:30 a.m. ET: 7,232,823 — Total deaths: 206,887 — Total recoveries: 2,840,688 — Total tests: 103,939,667Map.
  3. Education: School-aged children now make up 10% of all U.S COVID-19 cases.
  4. Health: Moderna says its coronavirus vaccine won't be ready until 2021
  5. Travel: CDC: 3,689 COVID-19 or coronavirus-like cases found on cruise ships in U.S. waters — Airlines begin mass layoffs while clinging to hope for federal aid
  6. Business: Real-time data show economy's rebound slowing but still going.
  7. Sports: Steelers-Titans NFL game delayed after coronavirus outbreak.

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