Hospital ERs: Show Us the Money
Last year, about 80,000 emergency-room patients at hospitals owned by HCA, the nation’s largest for-profit hospital chain, left without treatment after being told they would have to first pay $150 because they did not have a true emergency.
More from Phil Galewitz in the Kaiser Health News.
The question that may arise is, how accurate are these required screenings? What are the chances that these physicians dismiss a patient with some severe condition based on what a screening test tells them? As said in the article, 2 to 7 percent of patients dismissed for not showing serious problems are back within 24 hours.
This certainly seems a viable way to reduce the traffic in the ERs and help ER physicians focus on those patients with more serious conditions, leaving the least urgent cases to the clinic doctors. But to make it fair for all patients, they should make sure those screening tests used before admitting an individual into the ER are undoubtedly accurate. There should be no room for mistakes.
Undoubtedly, some patients don’t know enough about how bad of shape they are in when they go in thinking they have an emergency. Others may think they are in worse shape than they actually are.
If hospital ERs ever go just based on what the patient describes their symptoms to be, there is always a possibility of error if patients understate their medical situation.
Glad to hear it! HCA’s decision to charge non-urgent patients up front is not about being greedy. Rather, people need to understand health care is an expensive service that comes with a cost. The emergency room is arguably the least efficient way to provide primary or non-urgent care. We cannot expect to develop a retail market in health care when some people choose to free ride and expect primary care for free. I only hope HCA has a retail clinic or a primary care clinic it can refer patients to so that know their options.
The Emergency Room is the least cost-efficient place to provide primary care. In addition, regardless of whether a hospital is a for-profit or a non-profit institution, they should be able to decide which non-urgent patients are deserving of charity care. Some hospitals are banding together and setting up primary care clinics to refer non-urgent patients to. Providing primary care in an emergency room setting increases the probability that someone truly in need of urgent care will not be able to get it.
I talked to doctors who complain about providing charity care to indigent patients only to discover that their patient owns luxury items and could have afforded to pay a reasonable fee.
The howls of patient advocates notwithstanding, telling ununsured patients with significant but nonemergent medical issues to go to the Emergency Room is a ploy some physicians and allied providers use to try to finesse hospitals into providing uncompensated care. Given that nonurgent ED visits may account for up to 30% of the volume in some hospitals, HCA’s initiative is born of necessity. If and when the Feds initiate the same sort of screening would we hear the same objections from the same people?
Another disturbing trend is (insured) patients in the ED without true emergencies who were instructed to go there by their PCP’s office when they couldn’t be seen expeditiously.
Nice post. keep going.
Thanks!
Prakash
http://medicalinformationforyou.blogspot.in/