Monday, April 29, 2013

Health Care and Hospital Emergency Rooms

Hospitals have trauma centers that often double as emergency rooms for critical health and medical needs. Medical staff, including doctors and nurses as well as other critical care personnel, are typically on call 24/7 during their shifts and see all types of major life threatening and urgent healthcare issues. Individuals who use these can often be simply someone who does not have insurance and needs medical attention for any variety of ailments. As well, emergency rooms experience visits by fully insured individuals who may have had a serious accident, injury, or medical need. Emergency rooms are known for life saving treatment.

According to this website: http://www.howstuffworks.com/emergency-room.htm , a visit to the emergency room can be a stressful, scary event. Why is it so scary? First of all, there is the fear of not knowing what is wrong with you. There is the fear of having to visit an unfamiliar place filled with people you have never met. Also, you may have to undergo tests that you do not understand at a pace that discourages questions and comprehension.

According to a report published by HealthSprocket, here are the Top 10 reasons for emergency room diagnoses (2006) for visits:

1. Sprains and strains (6,375,245)
2. Superficial injury, contusion (6,107,869)
3. Other upper respiratory infections (5,285,382)
4. Abdominal pain (4,381,653)
5. Open wounds of extremities (3,697,836)
6. Spondylosis, intervertebral disc disorder, other back problems (3,236,278)
7. Nonspecific chest pain (3,018,660)
8. Headache, including migraine (2,825,233)
9. Open wounds of head, neck, and trunk (2,692,292)
10. Skin and subcutaneous tissue infections (2,610,735)

The information for these medical problems came from a study developed in 2006: HCUPnet. Healthcare Cost and Utilization Project (HCUP), 2006. Agency for Healthcare Research and Quality. Rockville, MD .

According to the Centers for Disease Control (CDC), here are the stats for the last year on record (2010) for emergency room visits:

• Number of visits: 129.8 million
• Number of injury-related visits: 37.9 million
• Number of visits per 100 persons: 42.8
• Percent of visits with patient seen in fewer than 15 minutes: 25.1%
• Percent of visits resulting in hospital admission: 13.3%
• Percent of visits resulting in transfer to a different (psychiatric or other) hospital: 2.1%

Source: National Hospital Ambulatory Medical Care Survey: 2010 Emergency Department Summary Tables, tables 1, 4, 14, 24; and this website: http://www.cdc.gov/nchs/fastats/ervisits.htm .

According to the New York Times, hospital emergency rooms, particularly those serving the urban poor, are closing at an alarming rate even as emergency visits are rising. Urban and suburban areas nationwide have lost a quarter of their capacity over the past twenty years, according to the study, in The Journal of the American Medical Association. In 1990, there were 2,446 hospitals with emergency departments in non-rural areas. That number dropped to 1,779 in 2009, even as the total number of emergency room visits nationwide increased by roughly 35 percent.

Emergency departments were most likely to have closed if they served large numbers of the poor, were at commercially operated hospitals, were in hospitals with skimpy profit margins or operated in highly competitive markets, the researchers found. Although the study did not examine emergency care at the remaining facilities, the closings take a toll on the quality of care in all emergency rooms according to Dr. Renee Y. Hsia, an assistant professor of emergency medicine at the University of California, San Francisco, and the lead author of the study.

According to the NY Times article, conditions in emergency rooms may be worsened by the new health care law, several experts said. The PPACA will expand eligibility for Medicaid, the government health plan for the poor. “Often beneficiaries turn to emergency rooms for care, because many physicians do not accept Medicaid payments”, said Dr. Sandra M. Schneider, president of the American College of Emergency Physicians. By federal law, emergency rooms are required by law to provide treatment regardless of ability to pay. More information can be found at this site: http://www.nytimes.com/2011/05/18/health/18hospital.html .

Emergency rooms provide a primary life saving option for patients in stress and trauma, whether the reason is due to illness or accident. The medical staff is highly trained to serve under pressure, and for the most part, able to accomplish in the majority of cases care that helps reduce the possibility of someone not recovering from their health care disaster.

Although emergency rooms are not really designed to handle day to day health care situations such as colds, sore throats, and non-life threatening issues. However, for anyone who is not insured, these locations often perform this function due to lack of available treatment options. Certainly, with ObamaCare in place, and due to ramp up starting in 2014, the lack of sufficient urgent care centers are going to suffer significant stress in their own right.

Until next time.

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