"If you think the overcrowding in Emergency Rooms across the country is because of uninsured, think again. A new study in the Annals of Emergency Medicine
They also found that most patients who frequently use the ED have health insurance and the majority of users (60%) were white. These findings contradict the widely held assumption that frequent users are minorities or illegal immigrants without insurance.
It is no surprise that frequent ED users tended to be sicker than occasional users and were more likely to be transported by ambulance. Chronic conditions like renal failure, COPD, asthma and sickle cell disease where common along with "pain". In urban areas like Boston and San Francisco, alcohol related visits and psychiatric conditions led to more frequent visits.
The principle reasons given by patients for using the ED included quick service and ability to receive free care. Most patients had Medicare or Medicaid as their primary insurer. reports that of patients who are frequent users (over 4 times a year) of Emergency Departments, the uninsured represent only 15% of those frequent users. Also the frequent ED users were more likely than occasional users to have visited a primary care physician in the previous year."
Found on the Everything Health blog...written by a Doctor.
good info! I do know from experience, though, that our local ER sees a lot of repeat "offenders" who are drug addicted or alcoholic (or both) and homeless. There circumstances make it almost impossible to take good care of themselves, so the inevitable crisis happens and sends them back to the ER. Some, but not all, are covered by insurance.
ReplyDeleteIt's a sad waste of hospital resources, but what is a civilized society to do?
Exactly. We are civilized and although we may not have reached the advanced stages of civilization that other countries enjoy, we should strive for it. We spend billions on the War on Drugs and that money goes for new helicopters and guns, not for clinics and programs that might help the drug addict and stop a new generation of drug users.
ReplyDeleteI think your blog looks so classy with the brown-on-brown theme. Very rich. Now, where did I put that chocolate...
ReplyDeleteYou're exactly right about the psych and substance abuse ER repeaters; all that started in the early 70's when we began to cut inpatient treatments for both problems. Then, in the eighties, we started cutting the funds for outpatient services. Then, managed care came in and cut insured patient visits/days of care. Then, the Republican administrations of the nineties cut the remaining funds. And now, state-funded programs for mental health and substance abuse are the first to be cut as insolvency looms. There's no place left, especially for the chronically mentally ill who suffer repeated bouts of acute episodes and for the truly addicted, who are always one acute episode away from self-annihilation.
It's not going to get better for ER medical providers or hospitals until the healthcare reforms provide consistent payment for non-emergent care. And so many states are petitioning to be excepted from the new law. That's totally shortsighted. The states can pay their EMS services, police departments, and fire departments to provide emergent response and, in some cases, even temporary "housing" for these patients, or they can pay for insurance coverage that provides real treatment and real prevention (I fervently hope); where there is hope of payment, the services will follow. I haven't done the math, but if we throw in money lost through unemployment and disability claims for these same individuals, I'm guessing it'll be a near wash.
And I just hijacked your blog. Sorry, buddy!
I wonder what the numbers are for public hospitals in urban areas?
ReplyDeleteWhen I broke my wrist a couple of months ago, I was too addled to call 911 -- I drove to the ER. I avoided Seattle's Harborview Medical Center (the public hospital) because I knew that I'd have to wait for 2-3 hours for treatment. I went to a suburban ER near my home; I was the only patient. They were happy for some action, even if it was just a wrist broken in a fall.
we live between rural and urban. Populations of 10,000 vs 70,000+
ReplyDeleteOne hospital in each. ER's in both areas are zoo's.