Health Care Wastefulness Is Detailed in Studies

[alp227]

Source: The New York Times

In a snapshot of systemic waste, researchers have calculated that more than half of the 354 million doctor visits made each year for acute medical care, like for fevers, stomachaches and coughs, are not with a patient’s primary physician, and that more than a quarter take place in hospital emergency rooms.

The authors of the study, which was published Tuesday in the journal Health Affairs, said it highlighted a significant question about the new federal health care law: can access to primary care be maintained, much less improved, when an already inadequate and inefficient system takes on an expected 32 million newly insured customers?

The study is the first to quantify the problem, according to Dr. Stephen R. Pitts, the lead author and an associate professor of emergency medicine at Emory University. Examining records of acute care visits from 2001 to 2004, the researchers concluded that 28 percent took place in emergency rooms, including almost all of the visits made on weekends and after office hours.

Read more: http://www.nytimes.com/2010/09/07/health/policy/07health.html

[Tx4obama]

1. I've heard Walmarts are going to have .....

a medical office where physician's assistants can take care of folks/kids with colds/flu/earaches etc.
That should bring down the emergency room visits quite a bit.
Especially in the larger cities where we have 24/7 Walmarts.

[JDPriestly]

2. That will be great until some physician's assistant misses

a heart condition or some signs of an aggressive cancer. Can and does happen, you know. Wonder how Walmart will like having to deal with that liability. I'm happy to have a physician's assistant deal with me provided that a doctor who knows me has signed off on the treatment.

[The Doctor.]

5. Oh, not to worry...

Wal-mart won't put those 'Medi-Marts' in until they've helped ram through tort-reform.

Hell, after that, anyone could practice medicine. They'd just be the cheapest.

[SharonAnn]

18. They are set up separately. Wal-Mart wouldn't be liable.

Corporations know how to set up different corporations to shield themselves from liability or taxes.

[st8grad93]

20. If the rules are like other "minute clinics"...

that already exist in Walgreens and CVS stores, then the PA / NP will be very restricted in what they can treat.

My ex looked into this while she was getting her NP license, and they basically have a list of 10 or 12 procedures they can do. Anything outside of that , like chest pain, is not treatable at the minute clinic and the patient must go elsewhere.

[On the Road]

19. That is a Really Good Development

It will give a lot more people in poorer neighborhoods access to basic health care. In my neighborhood, most people are without health insurance and either neglect medical treatment or use the emergency room.

[dkf]

3. To me the stuff that needs to be taken care of on the weekend is the stuff you really need a doctor

For. If you can make an appointment a week from now then it really wasn't very important was it?

[Iowa]

4. Unfortunately, people don't time their illnesses with M-F business hours.

If the shit hits the fan, it's likely to be on a Friday or Saturday night - especially with little kids. At least that's how it went with us when our kids were small.

[No Elephants]

8. I have a gift for getting very sick on Friday nights and long weekends.

Hit the Emergency Room thanksgiving morning and Labor Day weekend this year alone Admitted both times.

[hedgehog]

11. I always said, if you're worried about the kid, call by 2PM

if you don't want to be in the ER at 2AM. It's way cheaper and far more restful to be told that the kid'll be fine at 2PM in the doctor's office than to get the same news at 2AM in the ER. If the kid is seriously sick, he's better off getting treated by someone who knows him.

Of course, most mothers today see their kids only after finishing work for the day, when the doctors' offices are closed!

[Iowa]

14. Yep. But I don't think we ever had a kid that showed symptoms before 2 PM...

It's like it's wired into their genes or something.

I live in a rural area where the ER is total crap on weekday nights, but great on weekend nights, strangely enough. On weekends it's staffed 24/7 by a PA from out of town who is quite competent. On weekday nights it is closed. If you show up on a weekday night, you wait 5 minutes at a locked door until an (always) incompetent, slow-moving nurse comes down to unlock the door. She then diddles around trying to figure out a way to avoid calling a Dr. It's literally a death sentence if you're there with a life-threatening problem.

My daughter lives in a bigger town where they have access to a Dr's office until midnight. Pure luxury. We plan to move there in two or three years.

[hedgehog]

15. We had a young'en with asthma (this was 20 years ago before a lot of the new drugs

became standard) and assorted other mishaps with the other five so we had our share of going to the ER. Nothing is more frustrating than sitting in a small town ER with no other patients in sight, waiting with a sick kid sitting on a gurney listening to the staff chit chatting down the hall. I think they all watched ER and thought they were there to gossip and have interesting interpersonal relationships like on TV!

My favorite incident? The time we were sitting there waiting while some ambulance attendants chatted up the women at the nurse's station. All of a sudden, there was a real uproar. While the ambulance was left running unattended just outside the door, a person brought in for observation for mental illness was also going unattended. He got tired of sitting there doing nothing, so he walked down the hall, got into the ambulance, and drove himself home!

[Iowa]

16. Hilarious!

[ehrnst]

6. Community health centers - and not McDocs - are needed to address this.

We need walk-in care 24-7.

[Dappleganger]

7. Or at least centers with expanded hours.

[No Elephants]

9. Hospitals have accquired all of our community health centers and ended the chc's emergency care,

while raising prices and charging a fee for things that used to be free--like a $10 processing charge for filling out a short form to send blood or urine samples collected at the Center to the hospital lab for analysis. (Shuttles go back and forth to transport patients and the samples anyway. Always have.)

By "our, I mean Greater Boston's. I don't know what has gone on in the rest of America in that respect. I do know the mid-ineties also saw a flurry of hospital mergers around the country. I suspect both flurries resulted from changes in law.

Our dear, departed Senator Kennedy worked so hard to get health centers built, too.

At this point, Mass General controls every acute care hospital, every rehab hospital and every chc convenient for me to get health care.

[valerief]

10. BINGO!

[Still Blue in PDX]

13. Yes. nt

[hedgehog]

12. The long running series ER really documents how for 20 years

no significant changes were made in the US health care system. Think about this a minute; when ER started running, there were no personal computers, no cell phones, no DVDs etc. Technology changed everything else, but not the ER waiting room.

[superconnected]

17. Right - more scare about getting universal health care - yeah it sucks, but so does life without it.

We have to start somewhere, get people used to heath care and then used to regulating it. Without a start we will continue to have nothing.

[Overseas]

21. More evidence in favor of Medicare for All. Removes burden on ERs.

If we could afford to see regular doctors we wouldn't flood emergency rooms.