Long wait times, busy schedules, and complicated referral systems are among some of the reasons poorer Americans are more likely to visit hospital emergency rooms when they become ill, rather than visiting doctors' offices regularly.

A study published in Health Affairs on Monday found that there are numerous barriers in the health care system preventing poorer Americans from accessing essential preventative care. Instead of seeking care earlier, poorer Americans delay care until they become seriously sick, then go to hospitals when they need urgent care, HealthDay News reported.

"This was like holding up a magnifying lens to the problems of our health care system," Dr. Shreya Kangovi, lead author and physician at the Philadelphia Veterans Affairs Medical Center, told Kaiser Health News.

For the study, researchers interviewed 40 patients about why they went to the hospitals or emergency rooms to receive care. Based on their answers, they were categorized into two groups: socially dysfunctional or disabled patients who visited the hospital five or more times a month, and socially stable patients who found it hard to access outpatient care from a doctor's office.

Hospitals were considered a "one-stop shop" for the patients, providing shorter wait times, a range of health care services, and easier access than a doctor's office. The study also found that uninsured patients couldn't afford periodic visits to their doctors, and instead, resorted to visiting the emergency room, where charity care was given.

One woman said that her and her husband went to a wellness center for years, but their high blood pressure was not treated aggressively or brought under control. "I went to the hospital, and they had it under control in four days," she told researchers.

Visiting the emergency room costs about the same as a visit to the doctor's office, the study found, but it quickly becomes more expensive once a physician refers a patient to specialists. But while emergency room visits are cheaper for individuals, they cost more for hospitals — about $30.8 billion annually — because patients tend to visit more often for follow-up care. This pattern of care can also lead to less fortunate outcomes for patients' health in the future.

"An ER is not preventative," Vincent Keane, CEO of Unity Health Care Inc., told Kaiser. "It's not a good system for continuous care."

Dr. Kangovi conducted the study to find information that will help create a more efficient health care system. The government currently gauges hospital efficiency in many ways, including measuring the amount of readmissions to emergency rooms.

"This study debunks the perception that [poor] individuals abuse the emergency room and need to be educated on its proper use," Dr. David Grande, an assistant professor of medicine and co-author of the study, said in a news release. "To the contrary, these patients eloquently explained to us how we have built a health care system that incentivizes them to wait and get sick in order to get care that is more costly to society."

Source: Kangovi S, Barg F, Carter T, et al. Understanding Why Patients Of Low Socioeconomic Status Prefer Hospitals Over Ambulatory Care. Health Affairs. 2013.