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In a state with so much health insurance, why do so many people still go to the ER for non-emergency care?
By adamg on Tue, 09/29/2009 - 11:42am
A report last week indicated the number of non-emergency visits to Massachusetts emergency rooms hasn't really dropped since the state began requiring everybody to have health insurance.
Anya Rader Wallack, whose Blue Cross Blue Shield of Massachusetts Foundation helped fund the report explains some of the reasons why - most notably, people seeking medical care after their normal practitioners have gone home for the day:
... suggests that one way to significantly reduce ED visits in Massachusetts for non-emergency conditions is simply by offering care during evening and early morning hours as well as on weekends, or by managing more primary care needs over the phone (something for which physicians seldom receive reimbursement). ...
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Comments
Just a note
My gf's pcp has office hours till 8:00 pm. Thought that was odd but it can also be very convenient for people.
Off-hours non-emergency care options suck in Boston
As a father of five young children, I've dealt with many situations in which a member of my family needed to see someone for non-emergency care after hours or on a weekend. The fact of the matter is that off-hours non-emergency care options suck in Boston. There are very few urgent care-clinics at all, let along clinics that are open late or on weekends.
MinuteClinic has the potential to make a huge dent in this problem, if only they would open more of them and advertise the heck out of them. We live in Brighton, and the nearest MinuteClinic to us is in Somerville, and the people there said there were no plans to open one nearer to where we live. This is just absurd.
Another thing that's hard to understand is why the ER's that are overwhelmed by non-emergency patients don't run non-emergency clinics in parallel with their ER's.
I definitely agree. Friends
I definitely agree. Friends who live in other states always talk about the availability of Urgent Care. I think there might be one at Boston Medical Center? But certainly not sprinkled around the whole city.
Personally, I find it almost impossible to get a visit with my pcp within 4-6 weeks, even for something like an ear infection. Closer Minute Clinics or Urgent Care would be fantastic in this situation.
the only "urgent care" in Boston is at MGH
I think there might be one at Boston Medical Center
Nope. Not one in BMC, not in Faulkner, not in the Brigham. If you ask for one, you're told to go to the ER.
The one at MGH is staffed by barely a handful of docs and has about half a dozen exam rooms. For the largest city in the Northeast...?
To be pedantic, the
To be pedantic, the MinuteClinic you're probably talking about is officially in Cambridge, (and if there's one I'm not aware of actually in Somerville, this one is closer and T-accessible) although it's in Porter Square so it's extremely near the border.
Although it's not a completely pedantic distinction, since which side of the border you're on does make a difference because of the legal barriers to setting up those things. In particular, a big reason why there isn't a MinuteClinic in Brighton is that Menino has been actively opposing MinuteClinics. I do not know what Flaherty/Yoon think.
Health Insurance has little to do with ER visits
We've been to the ER probably half a dozen times in the past 5 years, mostly related to our kids. Things always seem to happen late Friday night or Sunday morning and what can you do? We call the urgent care and they can't see us because all their appointments are taken or they are closed and refer us to the ER. The urgent care people seem afraid to offer any medical advice that might result in a patient not seeking treatment. So off we go to the ER to sit and wait for hours for nothing.
The ER should be like it is on TV--a place where people come running in the door missing limbs and spraying blood all over the place, not holding a baby with a raspy cough. But because we lack that urgent care or even a competent phone triage, we feel like we have to go to the ER "just in case" the situation is worse than it appears.
Simple.
It takes 3 weeks to get a visit to my PCP even if I am "urgent" or really sick. I can go to the ER, pay an extra 20 bucks, and still be home in time to see which green-line trolley caught fire that particular evening.
Wow, an extra 20 bucks? I wish!
Our office visit copayment is $15. Our ER copayment is $100. And we've had to pay that copayment way too many times this year because our kids needed non-emergency treatment (spiking a fever, bad ear infection, etc.) at night or on weekends (more commonly the latter -- most of this stuff can wait until the next morning, but if a toddler spikes a fever on Friday afternoon, you can't really wait until Monday for him to see a doctor).
The last time something like this happened, we used the MinuteClinic in Somerville and it was fabulous. We'll definitely drive over there again if it's at all practical to do so, but I really think they need to open more MinuteClinics.
Menino opposes Minute Clinics
Another reason to vote against Menino.....he is firmly opposed to the Minute Clinics.
http://www.wickedlocal.com/roslindale/news/lifesty...
Maybe minute clinics are
Maybe minute clinics are slow to come about because king menino doesn't like minuteclinics.
http://www.wickedlocal.com/roslindale/news/lifesty...
http://www.boston.com/news/health/blog/2008/01/may...
To quote the mayor
It's not ok for retailers, but it is for insurance companies, Mr Mayor? And medical equipment suppliers? Pharmaceuticals? Half of downtown Boston is built around "making money off of sick people." And doesn't CVS pay taxes, Mr Mayor? Unlike the hospitals and their ERs?
And why all this personal concern about who may or may not "make money off of sick people"? Is that the critical criterion, not patient convenience, medical outcome and conservation of (extremely expensive) resources?
Something stinks here, and more and more, it seems its name is Menino.