Canadians overuse ER after hours: survey

[alp227]

Source: The Canadian Press

Canadians use emergency rooms more than people from 10 other countries, mainly because they can't get access to their regular medical care during weekends and evenings, a new survey says.

The survey — by the Health Council of Canada in conjunction with international groups — shows that nearly half the respondents who went to emergency rooms in the past two years could have been treated at their usual place of care if service had been available.

By contrast, in Germany, only a quarter of respondents said they were stuck going to emergency because no one else was available after hours.

Canadians also rank at the bottom when it comes to landing a doctor's appointment the same day or next day when they get sick or need quick attention.

Read more: http://www.cbc.ca/canada/story/2010/11/19/emergency-room-survey.html

---

From the Commonwealth Fund's press release:

A new 11-country survey from The Commonwealth Fund finds that adults in the United States are far more likely than those in 10 other industrialized nations to go without health care because of costs, have trouble paying medical bills, encounter high medical bills even when insured, and have disputes with their insurers or discover insurance wouldn’t pay as they expected. According to the report, the findings highlight the need for Affordable Care Act reforms that will ensure access to health care, protect people from medical debt, and simplify health insurance.

[polly7]

1. Do clinics in other countries operate in the evening and on weekends?

I work with EMS and live in Canada, the only time I see people in the ER during these times are if they're sick, hurt and needing emergency service. Is this different than in the U.S.? I also can see my doctor the same day, or next day 99% of the time. If I'm sick, I see him immediately.

[nadinbrzezinski]

3. In the US.... let me see

we have 45 million people who do not have access to basic care... they don't have insurance.

As a fellow EMT you will be horrified, I did this in Tijuana, and many a times I had to TALK my American patients who had NO INSURANCE, to let me take them to the ER after getting hurt, for example in a car crash. Why? They had no insurance... never mind we did not charge, but EMS in the US does, regularly.

[polly7]

5. That's sad. We've had a couple of people refuse the ambulance because it's not

covered in our district, they weren't serious cases and could get there safely without us, but you still worry.

[nadinbrzezinski]

9. One of the patients I talked into the

ride had neck pain. You know the drill, I know the drill... when they took an X-Ray he had a c-4, c-5 line fracture, that thankfully never displaced. Yep, he wore my collar to the ER, and the family chose to do the transfer to a US based hospital. Well, we did the transport as well.

And it's gotten far worst.

[Posteritatis]

4. It probably varies a lot by province too

Health (and education, and, well, everything else) is pretty poorly funded in Nova Scotia most of the time, and that affects accessibility outside of the standard hours, for instance.

[polly7]

15. Yes, I'm sure it does. I've just been checking and there are quite

a few clinics open 7 days a week in B.C., clinics in Regina have extended hours, I live in a rural area in SK and ours are not open evenings and weekends, but our doctors on call get to the hospital pretty quickly.

[jancantor]

6. Yes. They do in my area

There are several urgent care clinics in my area open near 24 hrs. They are preferable under my insurance (I don't have a copay for urgent care or doctor visit, but have a $50 copay for ER unless I am admitted).

I can see my doctor same day if I am sick, or at least another Dr. in her office. Heck, I got scheduled for an MRI same day I went in to see my doctor. Urgent care clinics are much more cost efficient and unless you really need an ER (serious trauma, etc.) urgent care clinics are the way to go imo. I am glad my insurance incentivizes them. For people w.o insurance, all too common in the US, there is no disincentive for the ER vs. the urgent care, if they aren't going to pay anyway

[virgogal]

12. I had to start the rabies shots about 10 years ago and was told by

my long-time MD that that was the only place I could get them,not at her office. (I have full coverage)

I went at 5:00AM to avoid a wait.

All worked out okay.

[jancantor]

13. My sympathies

I have heard that the sequence of shots is not fun.

[virgogal]

16. It beat the alternative.

[jancantor]

18. Frothing at the mouth?

I don't need no stinkin' rabies for that!

[ProudDad]

20. In the US...

for over 55 million persons...

The E.R. IS OUR ONLY PRIMARY CARE...

I'm on Medicare and I can't find a decent primary care doctor...and can't see a specialist without one...

So I've been advised to just hit the E.R. some night to get my hernia repaired...

I will probably have to do just that...

The USAmerican Empire has the shittiest health care delivery system in the civilized world...

WE DON'T HAVE CLINICS!!!

Canadians have it GREAT compared to us...

[cartach]

22. I may not go to my regular doctor

for a particular ailment because it might occur after regular office hours and need immediate attention,I might have to take time off my regular job with loss of pay if I work the same times and have the same days off as my regular doctor,a higher employment rate would increase the number of times this occrred,I may got to a doctor and have something looked at simply because I can and because it's more convenient for me during off hours, In this respect it's probably faster to go to a clinic during off hours because physical exams,certain tests and other more time consuming procedures are more likel to be looked at by a regular doctor during regular hours and by prearranged appointment. I could go and on but it really pisses me off to have to read claims like this which are not backed up with proof or conveniently exclude what the conclusions are based on. It's a form of fraud,a con job!

[XemaSab]

2. I understand some of the logic here

You're feeling slightly crappy all day, and you think "I can tough this out, and if it gets bad I can go to the doctor." Then it's like 10:00 and you realize that you're going to be miserable for the next 10 hours, so you go to the ER. :P

[glinda]

7. Is this part of the attempt to privatize Ca. health care? I would be suspect of this report.

Do know that there is somehow an American profit connection to hoping to add some things up there in order to push the health insurance, HC and Pharma market up there since Americans are now drained financially.
There are NO doctors available on weekends here. Emergency room and then wait til Monday if not totally dying for a doctor to come see you. Charges for the room and care though.

[polly7]

10. Certain groups in Canada have been trying to privatize our HC for

decades. If Harper had his way, it would be for-profit yesterday.

[Doctor_J]

11. Yup. This smells really bad

looks like Canada is getting hit with a propaganda onslaught. I heard they're about to get Fox "News" too.

TO my Canadian brethren - do whatever it takes to blow this shit up before it gets started. Our failure to deal with LImpballs, Ailes, Luntz, etc. 20 years ago has destroyed the US. If you start dealing with it now, it can probably be stopped. If you wait, you'll end up in fascist hell like we have.

[cartach]

24. You got that right! EOM

[Telly Savalas]

25. No. Read the report.

If you read the article in the OP, the report can be found with about 10 seconds of googling:

http://www.healthcouncilcanada.ca/docs/rpts/2010/comm/Commonwealth_FINAL_E_Nov2010.pdf

For almost all of the metrics Canada performs better than the United States.

The article itself cites the Council's recommendations:

The report proposes solutions, such as:

* Having primary health care clinics open longer hours.
* Using professionals like nurse practitioners to take away some of the burden on family doctors.
* A national pharmaceutical strategy to help ensure people don't skip or adjust a dose of a prescription medication because of cost concerns.


That doesn't exactly sound like it was lifted from the Tea Party Manifesto to me.

Good governments identify the deficiencies in their programs and work to fix them. That's what this report is all about. Perhaps if we did this in the U.S. instead of trying to shoehorn every issue into some bullshit cookie cutter narrative without even taking a second to assess the facts then our government wouldn't suck ass so much.

[glinda]

31. Awhile back I read that the way they sought to break into the Ca. HC market was

to offer more clinics with "Specialists" at extra cost. Sounded like they would be different in that they would somehow start to break apart the system of HC that you have. Wish that I could recall where I read it. If I recall it also said something about "offering competition". Beware of that crappie phrase!

[KoKo]

26. Absolutely.... Many DU'ers would have ridden this to ground and posted info..

but given the lethargy of us these days and our numbers dwindled...Why Bother.

Sounds like Petersen Foundation putting stuff out there to other sites where they regurgitate it back to the Blogosphere who doesn't have anyone FACT CHECKING!

It's a HOOT...however.

Amazing to see the machine in action to troops who've lost their leader and who don't have back ups.

Excellent Try...However. I wish you the success you are hoping for.

[Lasher]

8. Isn't it an emergency if you can't wait until your doctor's office is open in the morning?

Ground control to Major Tom: Your circuit's dead, there's something wong.

[Dappleganger]

14. Two days a week my doctor stays open later (7PM)

and is open on Saturday mornings from 8-12. There are two practitioners who work with her to help accomplish her goal of serving WORKING people. If we can't wait we go to the non-emergency facility down the street.

[sally cat]

17. It's the loophole in the system. Unintended consequences again.

[CHIMO]

19. Median wait at Sturgeon 19.7 hours

A local physician said he's not surprised that patients requiring treatment in the emergency department at St. Albert's Sturgeon Community Hospital waited a median average of 19.7 hours before being admitted for treatment, according to a third quarter report from Alberta Health Services.

Sturgeon had the second longest wait times in the province, according to the report.

“The stats are not surprising. We've had some significant challenges there for quite a while,” said Dr. Darryl LaBuick, a family physician at the Grandin Medical Clinic, who also sees patients at Sturgeon.

The median average means that half of patients waited longer while the other half were admitted sooner.

http://www.stalbertgazette.com/article/20101027/SAG0801/310279978

Dr. Raj Sherman apologizes to Alberta premier


EDMONTON - Dr. Raj Sherman made a heartfelt apology to Premier Ed Stelmach on Thursday, yet said he will continue to be a pain in the government's side if that's what it takes to help solve a crisis in hospital emergency rooms.

Instead of focusing his anger on his Tory colleagues, as he did Wednesday in a scathing e-mail that accused the premier of breaking a promise to fix health care, Sherman shifted much of the blame to the system's operator, Alberta Health Services.

The Conservative MLA for Edmonton-Meadowlark, who also works as an emergency room physician, said he felt a renewed respect for Stelmach and regretted sending the e-mail. But he also said he owes it to the public to remain an outspoken critic as long as the health system continues to struggle.

"I have to humbly apologize for making those comments to the premier. They were inappropriate and I shouldn't have said those things," said Sherman. "I am a passionate fellow, an emotional fellow and this is a very emotional subject to every Albertan."

http://www.edmontonjournal.com/health/Sherman+apologizes+premier/3850987/story.html

[ProudDad]

21. That's about average for County Hospitals here in the Empire...

If you have a lot of money, your wait times are lower...

[polly7]

28. That is awful, I didn't know things were that bad anywhere. We have

a shortage of nursing home access here right now too, but are much luckier becuase the new hospitals built all had special wings designated for long-term care from the start. I guess because we're so rural, we never see the long waits in emerg. I feel so bad for anyone waiting even half that long.

[cartach]

23. Walk in clinics/hospital emergency rooms

What are we talking about here? Obviously the writer doesn't know. There are walk in clinics all over the place open at night and on weekends which are a very good substitute for your regular doctor. Many are staffed by younger doctors who may have their own practise during regular hours and one man office elsewhere but need the extra money and have the energy to work a few evenings and weekends at a walk-in clinic. Hospital emergency rooms might take you in faster 24/7 if you have a real emergency or you wait longer if you don't. "in Germany only a quarter of the respondents said they were stuck going to an emergency room because no one else was available after hours" demands a fuller explanation.

[KoKo]

27. In the US...I've found "many" but not ALL of the Emergi Care Facilities quite good.

However at 3:00 a.m you are not going to find any care except Emergency Room at Hospital who will take you. Unfortunately you might wait until 7:00 a.m. or 10:00 a.m to be seen (at which point you could have suffered long enough to hit your "Emergi Care/Urgent Care Office" when they open at 8:00 a.m or 9:00 a.m. and been seen about the same time as your local Emergency Room.

HOWEVER! Unless you live in an URBAN AREA ...none of the ABOVE APPLY. If you are RURAL and need care then the time to get to a Hospital with an Emergency Room or any freestanding "outpatient" Emergi Care/Urgent Care Facility is almost not workable for you. The ambulance won't be paid for with your insurance if you live 50 miles outside of Urban and you could die in transit or the wait in the Urban Emergency room before you EVER GET SEEN because of the Back Log of Patients from all over needing urgent care.

We truly need to revise our system to save money and lives! We have to take care of our Rural and Far Suburban Populations so that when THEY NEED CARE they GET IT...CLOSER TO WHERE THEY LIVE. More COST EFFECTIVE!

[Nikia]

29. My experience is that it is quicker to go to a rural ER except during the day on weekends

They provide 24/7 coverage but don't have many patients come in the middle of the night. Depending on the case, they may transfer you to a bigger urban hospital, but then you come in with a high priority. My experience with an urban ER was hours waiting. In rural hospitals, I have been seen right away. I live in Wisconsin and had lived in Ohio. Maybe its different in different parts of the country.

[jpak]

30. Canadian doctors don't work nights and weekends like 'Merican doctors?

see what socialism gets you

:D