Do they matter: Emergency room visit #s?

[zork]

Wapo and NYtimes from a couple weeks ago discussed a Harvard study with comments by an MIT person:
The Link

and
The Link

Snippet from WaPo:

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[Seattle Husker]

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[theiioftx]

There is a growing trend of doctors who are not accepting new medicaid patients. Most administrators I work with expect increased pressure on their ER flow with much lower reimbursements.

I believe this was one noble goal of ACA that will also back fire with the reality of reimbursement for medicaid patients.

 

[hornpharmd]

one fix for the ER's would be to have urgent care centers incorporated in them so that those that show up at the ER but only need urgent care services can be treated there at a lower cost. And this does not tie up an ER bed/room.

ACA also includes incentives for hospitals to have better transition of care to decrease readmission rates. This should lead to less ER admissions from that popullation as well.

 

[Roger]

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[theiioftx]

Pharm is spot on here, but lots of regulations to navigate with referrals, licenses etc.

 

[Crockett]

Pharm: why would a hospital provide "urgent" treatment for $100-200. when the same patient might be charged $500 to $2000 revenue in the ER? I don't understand the system well, but in the suburbs where I live the ER facilitiesa appear to be sunk costs that are not under constant utilization. I assume doctor pay, nurse pay, supplies, etc. are going to be about the same either location.

 

[Uninformed]

Urgent care may not even have a physician present.

 

[theiioftx]

Couple of thoughts on ER care:

I think Pharm is advocating treatment options for people who do not need emergency room care. People show up in the ER with strep, viruses, etc that are treatable in a clinic.

Despite what will be billed, that is never what the hospital actually collects. An ER is full of expensive equipment and clinicians. You cannot effectively or efficiently treat common colds in that department.

 

[Roger]

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[hornpharmd]

ER's are often over crowded because many are there that do not need to be. Poor access to primary care, inadequate transition care, lack of an onsite urgent care area are just a few of the reasons. I look ahead at the new Seton teaching hospital for UT's new medical school. it will be a great place to implement and improve in these areas. many that go there for treatment will be medicaid, MAP, or just know that it is a county funded hospital. There can be huge savings in medical costs with better models that also utilize other practitioners (nurses, PA's, students, pharmacists, etc) in a multidisciplinary approach. or we can just keep treating them all in the ER just well enough so they can go home, giving them just enough medication to help them for a little while, not caring where they go or what happens to them when they leave, and then seeing them back in the ER soon. We can do better.