Have y'all seen this article? Apparently this is written by 2 ER docs, although they don't use Dr. in the article.
Their premise is that hospitals give preference to those with insurance. They find rooms for those who are transfers or direct admits before they do ER patients. The reason for that being that transfers and direct admits usually have insurance. People who come to the ER often have no insurance or are on medicaid or medicare. The hospital is paid less for the poor people on government aid for the same condition.
At my hospital, we rarely have people stay overnight in the ER. It does happen, but not often. Do I think this kind of policy goes on here? Its an interesting thought....I know that we often have patients waiting in the ER for beds and they are still giving beds to direct admits, out state transfers. It has made me wonder a time or two. I had the thought THESE ARE EMERGENCY PATIENTS SHOULDN'T THEY BE THE PRIORITY? They often aren't.
It would make sense that a institution would want to prioritize the patients of the doctors who bring their patients there on a regular basis. They want to keep the doctors business. They want to keep those out state referrals coming. That's why going on divert is discouraged. Those docs don't want their patients going to other hospitals. Understandable.
I don't think its that simple. Lack of beds is about - short staffing, more acute patients, inefficient discharge systems and the like. These authors think that ERs should be forced to publicize how long their average what is. What do you think?
5 comments:
In UK government has a target of 98% of patients attending an ED are seen, treated and discharged or admitted within 4 hours. Hospitals have been forced to look at the way care is delivered and it has become a hospital problem, not just an ED problem.
in a word, Yes.
it may not necessarily be because they have insurance, although I'm sure that has something to do with it.
I'm willing to bet that those with insurance are typically of a higher socio-economic class. That usually means they're more educated, which translates into a better understanding of their own health issues. If the patient understands what the doctors & nurses are telling them, they're more likely to participate in their own care -- rather than relying on health care professionals to "fix" them.
Those with insurance will usually have easier access to resources for follow-up treatments (if needed), such as babysitter, transportation, etc.
"At my hospital, we rarely have people stay overnight in the ER."
I didn't know there was such a place in America today. In our ED, on any given night, some of the nurses will get to practice their alternate roles as ICU, CCU, PCU, and MedSurg nurses.
you rarely have patients stay the night in your ER? We have patients stay for days. Seriously. When we're full, we dump office supplies out of closets and turn them into boarding areas where patients wait for rooms. Your patients should consider themselves lucky. Or my patients should consider themselves unlucky. I'm not sure which.
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Seems to me that the whole issue is way, way to complex to treat as merely a problem of insured/uninsured. Also, I'm (temporarily) on medicaid. I was recently admitted overnight for a respiratory problem. After the decision was made to admit me, I waited in the ER less than two hours before being moved upstairs. Anecdotal evidence isn't, but my experience as a medicaid patient has been better than my experience as a privately insured patient. I suspect it depends on dozens or hundreds of variables within each hospital.
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