Non-Urgent Response Essay

they must send them to another hospitals ED. Ambulances can drive around for unnecessary amounts of time trying to find a hospital with room in the emergency department for their victim. This can be scary for the victim. They present a huge health risk for patients seeking urgent medical attention. Ambulance diversions wouldn’t be an issue if overcrowding did not exist. Schull (2003) believes that ambulance diversion is driven by the boarding of patients and is not otherwise related to issues of staffing within the ED itself. (p.467-476)

A visit to the emergency department (ED) is usually associated with negative thoughts by most people. It creates preconceived images of overcrowded waiting rooms and routine long waits for treatment (Jarousse, 2011). From 1996 to 2006, ED visits increased annually from 90.3 million to 119.2 million (32% increase). During this same time period, the number of EDs has declined by 186 facilities creating the age old lower supply and greater demand concept (Crane & Noon, 2011). There are many contributing factors that have led to an increase in ED visits. A few of these key drivers include lack of primary care access, rising of the uninsured population, dwindling mental health services, and the growing elderly

The study revealed several issues in this department. Voluntary emergency patients have to wait extended periods of time before being transferred to the appropriate department. The majority of those who have to wait are those seeking mental health assistance. Keeping people in the emergency department longer than necessary cause operational costs skyrocket, and worse, keeps the needs of patients from properly being met.

When focusing on the Centers for Medicare and Medicaid Systems strategies for improvement with unnecessary emergency room visits, a major key area is accessibility to health care at the appropriate health care setting. For many years, there has been the perception that the emergency department is the only place for someone who is uninsured or underinsured can go to receive the needed and appropriate health care, and in some situations that may be the case. (Rhodes et al, 2013, p.394) Due to the decreases in reimbursements for the publicly funded, more and more physicians are opting out to treating these patients, thus leading to an increase in emergency department utilization. According to a study conducted by Rhodes, Bisgaier, Lawson, Soglen, Krug, and Haitsma, this is becoming a greater concern for the

The implications and effects on patients waiting long hours to be seen in the ED are immense. In a recent study done over five years in Ontario hospitals showed the risk of adverse events and even deaths increased with the length of stay in the ED (Science Daily, 2011). When EDs become overcrowded the quality of care changes and declines; which is extremely dangerous. Authors of the study calculated that if ED length of stay was cut by only an hour that 150 fewer Ontarians would die each year (Science Daily, 2011). Wait times can also negatively affect patients financially, untreated medical conditions can lead to reduced productivity and inability to work leading to increased financial strains (Fraser Institute, 2014). As well as delayed access to care can result in more complex interventions needed. Therefore an initiative is needed to provide patients with timely, efficient care when accessing

Many uninsured and underinsured focus group participants described going to emergency departments for non‐urgent care because they could not afford to pay for private care and knew they would not have to pay the emergency department charges and/or preferred to be seen as soon as possible. Several informants mentioned that the emergency department becomes a default source of primary care, which is costly and lacks the continuity of care that chronic conditions demand ("Community Health Needs Assessment,"

One of the primary goals of the Affordable Care Act (ACA) was to provide affordable health care coverage and increase access to affordable health care to the community. Unfortunately, since the passage of the ACA, while there has been an increase in the number of people with health care coverage, those same people do not necessarily have access to affordable health care. Currently, the public views the Emergency Department (ED) as a safety net by the community it serves; as demonstrated by the increasing number of people who continue to seek treatment in the ED for non-urgent problems. Utilization of the ED for non-urgent care contributes to the rising costs of healthcare as treatment in this setting can be upwards of three times the cost

The quality of care in an urgent care center is just a good in an emergency department for non-emergency care. The differentiating factor is follow-up care. Most emergency department physicians do not see their patients for follow-up care and only 2/3 of the patients will follow

Implications on Healthcare System: The general misuse of the Emergency Rooms as a replacement for patient’s primary care can be considered one reason why hospitals on Marcus Island represent the biggest hurdle with regards to healthcare cost containment. Patients are likely to use the ER for primary care because they know they will be seen on the same day at the ER, versus the potential wait time of 2-4 weeks to get an appointment to see their primary care provider. Inappropriate ER use is expensive for hospitals, and prohibits continuity of care for patients.

3) A study shows that availability of after-hours care by primary physicians reduces emergency room visits. Based on this study we can infer that it is likely that some of these individuals are forced to visit emergency rooms due the unavailability of after-hours care by primary physicians and lack of paid sick leave to reach the primary care physician during regular work hours. Paid sick leave will reduce the emergency room visits as employees can now contact their primary care physicians during work hours.

Urgent care clinics are for individuals seeking non-life threatening treatment. These clinics provide another level of care to the community and the intentions of urgent care are not to replace emergency

Francis, M., Rich, T., Williamson, T., & Peterson, D. (2010). Effect of an emergency department

The Centers for Disease Control and Prevention (CDC, 2017) notes the following statistics pertaining to Emergency Department (ED) visits in the United States during 2013: (a) number of visits-130.4, (b) number of injury-related visits-37.2 million, (c) number of visits per 100 persons-41.9, (d) number of ED visits resulting in hospital admission 12.2 million, (e) number of ED visits resulting in admission to critical care unit-1.5 million, (f) percent of visits with patient seen in fewer than 15 minutes-29.8%, (g) percent of visits resulting in hospital admission-9.3%, and (h) percent of visits resulting in transfer to a different (psychiatric or their) hospital-2.2%.

Tang N, Stein J, Hsia RY et al: Trends and characteristics and US emergency department visits, 1997 – 2007.  JAMA 2010; 304: 664-670

The emergency room has become the new primary care facility for the millions of uninsured in the United States. Thanks to an “unfunded mandate passed into law in 1986,” hospitals that participate in the Medicare program must “screen and treat anyone with an emergency medical condition” (Stephens & Ledlow, 2010). This unfortunately leads to emergency rooms full of people who may have something as simple as a sinus infection which then makes it really difficult for someone with a real emergency that did not require ambulatory transport to be seen in a timely manner. Another unfortunate result of this is that “over 1,100 emergency departments closed over the past decade” (Stephens & Ledlow, 2010).