All posts tagged health-insurance

Report finds many emergency room visits are avoidable – ConsumerAffairs

When an accident or injury occurs, its second nature for consumers to go to the emergency room (ER) for treatment. But a new report finds that some of these visits arent necessary or advisable.

In a recent study, researchers from California deemed that 3.5% of all U.S. emergency roomvisits were avoidable. They say that the top three discharge diagnoses were alcohol abuse, dental disorders, and mood disorders, such as anxiety and depression. While some of these conditions can be serious, the authors note that the ER is not always necessarily the best place to have them treated.

Our most striking finding is that a significant number of avoidable visits are for conditions the ED is not equipped to treat. Emergency physicians are trained to treat life- and limb-threatening emergencies, making it inefficient for patients with mental health, substance abuse, or dental disorders to be treated in this setting, they said.

The study analyzed over 424 million visits made to emergency departments across the U.S. between 2005 and 2011 for patients aged 18 to 64. Avoidable cases were defined as those that did not require diagnostic or screening services, procedures, or medications, and led to patients being discharged home.

Of these visits, the researchers say that 6.8% were related to alcohol abuse or mood disorders, while 3.9% were connected to disorders with patients teeth or jaws. While the majorityof these visits did warrant emergency attention, the results indicated that 16.9% of mood disorder visits, 10.4% of alcohol-related visits, and 4.9% of tooth and jaw-related visits were avoidable.

While visiting the ER might seem like the safest move, the researchers note that extraneous visits can impact the overall cost of health insurance for all consumers. They believe that their results may indicate a need to increase public access to mental health services and dental care.

Our findings serve as a start to addressing gaps in the US healthcare system, rather than penalizing patients for lack of access, and may be a better step to decreasing avoidable ED visits, the researchers concluded.

The full study has been published in the International Journal for Quality in Health Care.

Report finds many emergency room visits are avoidable – ConsumerAffairs


Medicaid expansion didn’t lead to overwhelmed emergency rooms … – Baltimore Sun

After the Affordable Care Act expanded access to Medicaid, some worried that newly insured patients would overwhelm emergency rooms, but those concerns appear unfounded, according to new research from Johns Hopkins Medicine.

The study comes as lawmakers in Washington consider legislation to scale back the federal-state health insurance program for low-income people as part of a larger overhaul of the health care reform known as Obamacare.

Through the Medicaid expansion, there were some people who believed more patients would choose to go to primary care providers instead of the emergency department, because now they have health coverage, and there were some people who believed that the expansion would swamp the emergency department, said Eili Klein, assistant professor of emergency medicine in Hopkins School of Medicine. We wanted to look at what actually happened.

Thirty-two states expanded their Medicaid programs. In a paper published this week in the Annals of Emergency Medicine, Hopkins researchers looked at billing data from Maryland during 18 months before and after enrollment in the health program began in 2014.

Marylands Medicaid rolls swelled by about 20 percent, or 160,000 people. About 800,0000 already were enrolled in the program.

Overall, the study found there was a 1 percent decrease in emergency room use over the study period despite an increase in the number of insured people.

Those new to Medicaid did use the emergency room more about 43 percent more than people without insurance, Klein said. But most people dont visit the emergency room much, and the growth in Medicaid enrollees wasnt enough to have much of an effect.

Among those using the emergency room, there was a six percent increase in those with Medicaid coverage and a corresponding decrease in those with no insurance.

Klein said the financial benefits to patients was positive because they werent stuck with bills they couldnt pay, and the hospitals bottom lines were protected from uncompensated care.

Originally posted here:
Medicaid expansion didn’t lead to overwhelmed emergency rooms … – Baltimore Sun