Emergency rooms have largely been blamed for excessive health care costs, but popular cost-cutting measures may be doing more harm than good for patient care, according to a new study published in the Journal of the American Medical Association.
Reducing ER visits for non-urgent care, which can cost up to five times more than care provided in a doctor's office, is a measure adopted by many hospitals. Several states proposed a policy to pay the bills for true emergencies, like a heart attack or ruptured aneurysm, but reduce or deny reimbursements for less serious cases like heartburn or constipation.
The problem with this method, according to the study, is the assumption that patients can predict the urgency of their diagnosis themselves based on initial symptoms. By reviewing nationwide records of nearly 35,000 ER visits, researchers found that nearly 90 percent of urgent cases presented the same primary symptoms, including abdominal discomfort, chest pain and fever, as the 6 percent of cases that were discharged and could have been treated in a doctor's office.
The state of Washington has instituted a different policy. By establishing programs designed to educate patients on how to access care and other statewide guidelines, as well as creating regularly updated reports on how emergency department resources are utilized, the state's policy has resulted in projected savings of over $31 million by the end of the fiscal year.
"A policy that requires more coordination and more tailoring means more work than one that slashes benefits across the board," said Dr. Renee Y. Hsia, senior author of the study. "But it is the right thing to do for patients." Read the full details here:
Services and staffing at emergency rooms throughout the country have been steadily cut over the last decade. This has led to increased wait times, poor medical care and numerous patients who are ignored or sent home despite having illnesses deserving of admission to the hospital.
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