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?
According to the American College of Emergency Physicians (www.acep.org), “Emergency visit rates have increased at twice the rate of growth of the U.S. population from 1997 to 2007 (JAMA 2010), and nearly two-thirds of emergency departments are now classified as safety net hospitals — defined as providing a “disproportionate share of services to Medicaid and uninsured patients —-nearly double from 1997.”
In addition, “Annals of Emergency Medicine in 2007 found the rates of emergency visits by the elderly are increasing more rapidly than any other group, which study authors predict would lead to “catastrophic” overcrowding.”
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.