Sunday, March 31, 2013

Why are Emergency Departments Overcrowded Yet Disappearing?

My opinion:  Arguably, emergency departments are perhaps one of the most important cornerstones of modern medicine.  These places treat the people who need it most, yet, it is becoming more and more difficult to find them and actually get treatment without waiting forever.  In Cleveland, these recently closed Huron Hospital and its emergency department.  Not only did this reduce healthcare access, but it reduced it to people in a rather poor neighborhood.  Now, those people must travel longer distances to get to an ER.  Thus, the location of the ER might be a significant part of the problem, as well as the doctor shortage.  Perhaps some of these ERs could run temporarily if they had more doctors, but then the facilities would have to be larger, as well.  Ultimately, more ER departments are necessary.  To deal with the money problem, I'm wondering if hospitals could focus their finances in the ER.  With so many people in and out of the department, do they lose track of unpaid dues?  And on a final note, is it possible to lower the cost of healthcare for the uninsured?  Please feel free to comment on this widespread issue.

From: http://code3spots.com/blog/overburdened-emergency-department/

Emergency Medicine Physicians are well aware of the realities of overcrowded and overburdened emergency departments—a growing problem across the country that impacts all emergency medicine jobs.
“These problems are only getting worse as the “lack of access” to care grows,” said Dr. Melissa Barton of Sinai-Grace Hospital in Detroit, Michigan. “Patients may have insurance but are unable to get into a walk-in appointment with their doctor for weeks; unable to get the needed referral for a specialist. The Emergency Department really isn’t the cause of increasing healthcare costs. In fact, the contrary, and a great bang for your buck.”
The main questions are, how did this happen and can it be fixed?

The common myth is that uninsured people are seeking non-urgent medical care, but in fact these make up less than 8% of emergency room patients. The ACEP dispels this myth though:
“Myth: We all share the cost of treating the uninsured in emergency departments.
Fact:?Cost sharing occurs, but uncompensated care has closed hundreds of emergency departments in the United States. A significant burden for treating the uninsured also is borne by emergency physicians, who provide an average of $138,000 in uncompensated care every year, and by the uninsured themselves, who are charged the highest rate for care. In fact, uninsured patients pay a higher proportion of emergency department charges than Medicaid patients (Annals of Emergency Medicine, Renee Hsia, 2007). The Hsia study showed that overall less than 50 percent of all emergency department charges are reimbursed.”
As for a solution, the hope is that healthcare reform will eventually lead to changes to ease the overcrowding, though using Massachusetts as an example, it appears that will not have an immediate effect on emergency departments–especially as emergency department visits continue to rise.

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