tag:blogger.com,1999:blog-32053362.post5455242500926079850..comments2024-03-29T06:37:18.029-04:00Comments on Not Running a Hospital: With insurance available, ED visits risePaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-32053362.post-64917045043995257362014-03-28T23:06:34.996-04:002014-03-28T23:06:34.996-04:00the data does account for two changes in Healthca...the data does account for two changes in Healthcare delivery, first a general trend by pcp to send walkins to the er rather than interrupt a busy office schedule and secondly insurance preauthorization requirements and Medicare rules make it easier to send to the er. More than 80 percent of hospital admits are now through the er. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-73145928519402705202014-03-28T12:07:26.139-04:002014-03-28T12:07:26.139-04:00If you insure a popoulation that has traditionally...If you insure a popoulation that has traditionally only had access to care through the emrgency room, it stands to reason they will continue to use this as their main source of care. Only if health care systems are incentivised to try to re-direct this care to less costly settings will they actually do so.<br /><br />Also, giving patients Medicaid with its poor levels of reimbursement does not mean these patients will have easier access to primary care.Keithnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-90696520157722554922014-03-28T11:38:00.015-04:002014-03-28T11:38:00.015-04:00Paul - If something can't go on forever, it wo...Paul - If something can't go on forever, it won't. This rise in federal and state spending (much of it on healthcare) can not continue to rise as it will bankrupt us at every level. We have a $17 trillion national debt and growing AND $128 trillion in future unfunded liabilities for Medicare and Social Security. So here we are handing out more free health insurance which just adds to the problem. This will break at some point and it is not going to be pretty. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-90633672998059361812014-03-28T10:30:00.418-04:002014-03-28T10:30:00.418-04:00This is only a surprise because people did not stu...This is only a surprise because people did not study human behavior first. Rather than placing all clinics in neighborhoods, most should have been placed next to or near every busy emergency room. Then referrals could have gone from the ER to the clinic rather than the person failing to get an appointment (or not knowing how) ending up in the ER.<br />Guaranteed the folks seeking help this way are of low income with few resources and are doing the only thing that makes sense to them - if you need help you get a doctor and doctors are at the hospital. The people that designed the flawed system are in shock that it does not work, but those of us watching this unfold predicted exactly this behavior which will increase costs and result in even worse service.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-68033062341824973462014-03-28T08:28:41.354-04:002014-03-28T08:28:41.354-04:00Is there any data on the extent to which the growt...Is there any data on the extent to which the growth in ER visits is being driven by lower income people? I think there was an article in Health Affairs not long ago that described how low income people find the ER more convenient for them and they perceive it as higher quality than community based care that they may have access to. They also see the ER as a one stop shop where they can get imaging and other necessary services all in the same visit. Many of these people don’t have cars and can’t easily take time off from work to visit specialists or imaging centers so they go to the ER instead even if the issue is not absolutely urgent. I’m not sure what the answer is aside from hospitals maybe having a walk-in clinic next to or near the ER than non-urgent cases can be directed to.Barry Carolnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-49560125839482639372014-03-28T07:10:54.759-04:002014-03-28T07:10:54.759-04:00Here's the problem: most of my doctors are ove...Here's the problem: most of my doctors are overloaded and it can take weeks to months to get an appointment. Once you are in, if you don't have an appt. they tell you to go to the ER. So the ER is listed as a 'catch all'. Same for most urgent care as they have to send you there for things as they don't have CT scans, ultrasounds, etc.<br /><br />That is messed up. Anonymousnoreply@blogger.com