Half of Trips to Emergency Rooms Found Not Urgent : Health: Family doctors could handle problems at one-third of the expense. Government study shows how uninsured Americans push up costs for others.

More than half of the 90 million annual visits to the nation’s hospital emergency rooms are for non-emergencies that can be treated by a family doctor--at a third of the cost, a national survey found Wednesday.

Almost as many people visited an emergency room for sore throats and coughs as for chest pains, said the study by the National Center for Health Statistics, an agency of the Department of Health and Human Services.

The findings are likely to figure in the health care reform debate because they offer vivid proof that most uninsured Americans have no regular form of medical care and because they demonstrate how those Americans’ lack of coverage pushes up insurance costs for others. An estimated 38 million Americans have no health insurance.

The study found, for instance, that those with the highest rate of non-emergency visits were under age 24--the group least likely to have insurance. Sixty-one percent of their visits were not emergencies--compared to the overall rate of 55%.

“This study shows how emergency rooms have become the ‘family doctor’ for too many Americans,” HHS Secretary Donna Shalala said. “But emergency rooms are not intended to deliver routine medical care.

“Patients at emergency rooms don’t get the timely, preventive services that come with regular medical care. And the cost is three times higher than visits to the doctor’s office.”

The high rate of non-urgent use of emergency rooms is not surprising, said Kate Perrin, an official of the American College of Emergency Physicians.

“There has been a tremendous and growing reliance on emergency departments to provide care for segments of our population that are no longer covered in traditional ways,” Perrin said.

Despite the high incidence of non-emergencies, the patients treated were given an abundance of diagnostic tests, many of them expensive. The study said 73.7% of visitors had their blood pressure taken, 28.7% had blood work-ups, 16.8% received chest X-rays, 13.2% had electrocardiograms and 2.4% underwent CAT scans or magnetic resonance imaging.

The study expanded upon two studies released last year, one by the General Accounting Office, the other by the American Hospital Assn. The GAO study concluded that 43% of visits to emergency rooms in 1990 were not urgent. The AHA study said one of three emergency room visits were made by people seeking primary care.

The latest study covered 1992 and was based on a sampling of 432 hospitals around the country, said author Linda F. McCaig, a researcher at the center. By design, hospitals that might skew the results were excluded, such as federal facilities or those with a preponderance of chronically ill patients.

The study said 42% of all visitors had Medicare or Medicaid coverage and another 36% had private insurance. Most of the rest, McCaig said, were uninsured and could not pay for their treatment.

In his drive to overhaul the health care system, President Clinton has made universal coverage his guiding principle. Administration officials have stressed that the cost of treating the uninsured is passed on to the insured through higher fees. Such cost-shifting will continue, experts agree, unless all Americans have insurance.

Also Wednesday, reporters asked Clinton about two new polls that show significant erosion in public support for his health care plan.

“How could it be otherwise?” Clinton said. “I mean, look at the millions and millions and millions of dollars that have been spent by interest groups to trash the plan, people that don’t want to assume any responsibility for their employees, people that don’t want to assume any responsibility for providing basic health care, people that think they can get just a little better deal.”

Nevertheless, the President said: “I still am actually pretty optimistic about this, because what happened is, every time I get a chance to speak to the American people about it, support goes back up, like it did at the State of the Union.”

A Washington Post-ABC News poll found that, for the first time, more people disapprove of Clinton’s plan than approve, by a 48%-44% margin. And a CNN-USA Today poll found an 11-point decline in support for the plan since a month ago.

Separately, the leaders of the House Energy and Commerce Committee decided to bypass the customary step of having a subcommittee consider the plan before sending it to the full committee.

In part, the decision is in the interest of time. Health subcommittee Chairman Henry A. Waxman (D-Los Angeles) said he and Chairman John D. Dingell (D-Mich.) are concerned that they will not have the cost estimates they will need to draft their version for several weeks.

However, a larger problem is with the moderate and conservative Democrats on the panel who oppose the President’s plan to require employers to provide their workers with health coverage, as well as the premium caps in the measure.

Times staff writer Karen Tumulty contributed to this story.