ED Treatment now Requires an ED Visit

[somarco]

Today, U.S. emergency departments (EDs) face a similar conundrum -- seemingly limitless demand for emergency services. Beginning in 2012, the annual number of ED visitsopens in a new tab or window nationally jumped from 131 to 150 millionopens in a new tab or window in just 7 years, easily outstripping population growth. A recent studyopens in a new tab or window in California found that from 2011 through 2019, ED visits increased 23.4% while the state's population grew by only 5%.

Concurrently, measures of ED overcrowding and dysfunction have also skyrocketed. From 2017 through 2021, the median percentage of ED patients nationally who left without being seen (LWBS) doubled from 1% to 2%. Another study found that by the end of 2021, boarding in a sampling of academic EDs had surged 40%opens in a new tab or window beyond pre-pandemic levels. Many EDs now find themselves in a state of gridlock worthy of the I-405.

NOTE: ED treatment is NOT considered a medical necessity and is not covered by Medicare. You should likewise not expect Medicare to pay for an ambulance ride to the ED.

Opinion | If You Build It, They Will Come: EDs Are Victims of Induced Demand

We cannot simply build our way out of the overcrowding and boarding crisis

www.medpagetoday.com

 

[LostDollar]

One might want to give some consideration to some of the reasons behind increased demand for emergency department services.

 

[axeman462]

Lol I thought you were taking this convo in a different direction based on the title...

 

[kgmom219]

Starting with “she’s fine”.

Mom had a CT last Tuesday due to shortness of breath.

Wednesday, her PCP got the results and it showed fluid between her heart and lung cavity. Sent us to the Emergency Room.

First, they were expecting us.
Second, it’s a 90/10 issue. Either 90% no big deal or 10% emergency surgery.

The problem? It’s the only way to get an immediate cardiologist answer. Mom sees her cardiologist annually, last time was 3 months ago. (All of her annual doc appts are in 2nd quarter, too. I’m an only child.)

We walked right in. Showed her Medicare card and they wheeled into her a room. Had me stay in the waiting room for a bit. 2 more people came in but they had Advantage plans so it was a huge mess of paperwork and money. Then they got a room.

Theres a reason ER visits are skyrocketing and it’s not just about insurance

 

[somarco]

Good things come to those who understand the bureaucracy and how to successfully navigate the system.

Most seniors have no idea how to fight the system so they just do as they are told and end up paying claims that never should have been denied.

 

[LostDollar]

The problem? It’s the only way to get an immediate cardiologist answer. Mom sees her cardiologist annually, last time was 3 months ago. (All of her annual doc appts are in 2nd quarter, too. I’m an only child.)

My cardiologist and PCP expect to see me every 3 months. However, even with that, as you suggest it's very likely they would send me to the emergency room if a serious problem popped up.

 

[kgmom219]

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My cardiologist and PCP expect to see me every 3 months. However, even with that, as you suggest it's very likely they would send me to the emergency room if a serious problem popped up.

She has zero heart issues.

Her daughter thinks people over 70 should have a cardiologist. Period.

Trust me, she’s got plenty of doc appts

 

[LostDollar]

Theres a reason ER visits are skyrocketing and it’s not just about insurance

That statement makes it sound to me like you indirectly expressed an opinion about one or more of the reasons in your post. I am not clever enough to suss that out.

It seems to me one of the reasons for increased ER visits would be a shrinking supply of Family Practice Docs.

 

[kgmom219]

That statement makes it sound to me like you indirectly expressed an opinion about one or more of the reasons in your post. I am not clever enough to suss that out.

It seems to me one of the reasons for increased ER visits would be a shrinking supply of Family Practice Docs.

No.

It’s not that. Or only that.

It’s that PCPs can’t make tough decisions and ER is the quickest way