Two Texas ERs to turn away non-emergency patients
One of the more pressing medical issues today is the average ED department: not enough beds for the incoming cases. A big contributor to this phenomenon is that the ER is widely used as a primary care center, particularly for the uninsured. Major cities like Washington DC, NYC, and Boston often go on "drive-by" status where the hospital closes its doors to ambulances, because they're simply too full to cope to handle any more patients.
A new initiative at two hospitals in the Houston area will try to ease the burden on ERs starting today. By pre-screening adult patients, the Ben Taub and LBJ hospitals will require those who don't need emergency care to seek treatment at community health clinics, or else pay a relatively hefty fee: a $150 deposit. A deposit at an urgent care setting will run $80. Actual cost for treatment will be on a sliding scale based on a patient's ability to pay.
Personally, I think it's a brilliant strategy. As someone who spent about 4 hours — thankfully mostly unconscious — waiting for a bed in an ER to open up, it stinks when you've got to wait for ages when you truly do need emergency care. (And I was lucky!)
Another phenomenon that ERs face that this new initiative will combat is the problem of those who wait until they are very sick to seek medical treatment. Uninsured people typically wait until their symptoms become unbearable before seeking treatment because they can't afford to pay for medical care. This new program will likely have an impact on this phenomenon as well:
RightCare will try to get patients established in "a medical home" — a clinic or other setting where they can receive ongoing primary care treatment, Martinez said.
If successful, the up-front $650,000 cost to build an ambulatory clinic will likely be recouped in savings to the hospitals since treating non-emergency cases is inherently less expensive outside an ER.
He said patients come to emergency rooms for sore throats and minor stomachaches, and some bring children for immunization shots.
The district predicts the diversion policy will cut emergency room visits by 20 percent, Hearn said.
The first sentence there is the reason that Medicare Part D will largely fund itself — by allowing seniors greater access to medications, the government will actually be saving money because prevention is inherently less expensive than treatment. It costs more to hospitalize someone — where they get their meds for free — than it does to pay for preventative medications. A lot more. (Even when drug therapy involves brand-name drugs and expensive, targeted cancer therapies.)
As a taxpayer, I hope we see more initiatives like this. I have a feeling strained ERs all over the country will be watching this experiment with great interest.
[tags]Medicine, pharmacy, emergency rooms, economics, medicare[/tags]
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[...] So at the one end, you've got your emergency rooms, and on the other, you've got your concierge medicine. In the middle, you've got urgent care clinics that see patients that fall in the middle of the spectrum. I suspect we'll be seeing more of these clinics as ERs become increasingly overcrowded, and start turning away non-urgent cases. [...]
Pingback by Entrepreneurs and medicine: the urgent care clinic phenomenon :: OnThePharm — August 22, 2006 @ 9:56 am