ER Visits Mostly by Medicare, Medicaid Recipients

ER Visits Mostly by Medicare, Medicaid Recipients
But government study also shows uninsured accounted for almost 1 out of 5 ER patients

FRIDAY, July 31 (HealthDay News) -- An estimated 50 million, or 42 percent, of the 120 million visits made in 2006 to U.S. hospital emergency departments were billed to the Medicaid and Medicare programs, according to a U.S. government report released Thursday.

Uninsured patients accounted for nearly 18 percent of emergency department visits nationally, 34 percent were billed to private insurance, and 6 percent were billed to worker's compensation, military health plan administrator Tricare, and other payers, according to the latest News and Numbers from the U.S. Agency for Healthcare Research and Quality.

Among the other findings:

Of the 24.2 million emergency department visits billed to Medicare, 38.3 percent ended with the patients being admitted, compared with 11.2 percent of the 41.5 million visits billed to private insurers, 9.5 percent of the 26 million visits billed to Medicaid, and 6.8 percent of the 21.2 million visits by the uninsured.
Uninsured patients were the most frequent users of hospital emergency departments. Their rate of 452 visits per 1,000 people was 1.2 times greater than the rate of 367 per 1,000 people among patients with public or private insurance.
The "treat-and-release" rate for uninsured patients was 421 visits per 1,000 people, compared with 301 visits per 1,000 for those with insurance. This is a possible indication that people without insurance use hospital emergency departments as their usual source of care.
The study is based on an analysis of data from the 2006 Nationwide Emergency Department Sample, which contains records of emergency department visits from about 1,000 community hospitals nationwide. The hospitals account for 20 percent of all U.S. hospital emergency departments.

More information

The American College of Emergency Physicians explains when patients should go to the emergency department: see below

-- Robert Preidt

SOURCE: U.S. Agency for Healthcare Research and Quality, news release, July 30, 2009
http://www.healthday.com/Article.asp?AID=629550

When Should I Go to the Emergency Department?

More than 300,000 Americans on average are treated in our nation's emergency departments every day, according to the latest government statistics, and patients are treated for a wide variety of medical conditions.

How do you decide when a medical condition rises to the level of a medical "emergency?" The American College of Emergency Physicians (ACEP) offers a list of warning signs that indicate a medical emergency, which are also available with additional health and safety information on the organization's Web site.

•Difficulty breathing, shortness of breath
•Chest or upper abdominal pain or pressure
•Fainting, sudden dizziness, weakness
•Changes in vision
•Confusion or changes in mental status
•Any sudden or severe pain
•Uncontrolled bleeding
•Severe or persistent vomiting or diarrhea
•Coughing or vomiting blood
•Suicidal feelings
•Difficulty speaking
•Shortness of breath
•Unusual abdominal pain
Children have unique medical problems and may display different symptoms than adults. Symptoms that are serious for a child may not be as serious for an adult. Children may also be unable to communicate their condition, which means an adult will have to interpret the behavior. Always get immediate medical attention if you think your child is having a medical emergency.

"If you or a loved one think you need emergency care, come to the emergency department and have a doctor examine you," said Dr. Frederick Blum, president of ACEP. "If you think the medical condition is life-threatening or the person's condition will worsen on the way to the hospital, then you need to call
9-1-1 and have your local Emergency Medical Services provider come to you."

Emergency departments see patients based on the severity of their illnesses or injuries, not on a first-come, first serve basis. With that in mind, ACEP offers the following tips to patients when they come to an emergency department in order to get the best possible care as quickly as possible:

•Bring a list of medications and allergies: What's the name of the medication you are taking? How often do you take it and for how long? A list of allergies is important, especially if there are many of them. Be sure to include medications, foods, insects or any other product that may cause an allergic reaction. Bring a medical history form with you. ACEP has medical history forms available on its Web site.
•Know your immunizations: This will likely be a long list for children; mainly tetanus, flu and Hepatitis B for adults.
•Remain calm: Obviously it is difficult to remain composed if you've been badly injured, but a calm attitude can help increase communication with the doctors and nurses who are caring for you.
Communication is important when you arrive at an emergency department," said Dr. Blum. "I want to know as much about the patient, as I can as quickly as I can, so the proper treatment can begin. There can be long waits in the emergency department as doctors and nurse tend to those with the most severe conditions, but by all means tell us if you are in pain or there is any change in your condition while you're at the hospital."

ACEP is a national medical specialty society representing emergency medicine with nearly 24,000 members. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.