Tuesday, May 31, 2005

Emergency Rooms

For the truly bored at heart:

http://www.cdc.gov/nchs/data/ad/ad358.pdf

It is the latest ambulance Care Medical Survey. It is packed with a wealth of statistics and Tables, sufficient to numb the most brazen mind. It has only a few problems, like they don't use the same language as humanity, but it give a clear picture of Emergency Health Care today.

From 1993 to 2003, the number of ED visits increased from 90.3 million to 113.9 million visits annually (up 26 percent). This represents an average increase of more than 2 million visits per year. The number of hospital EDs in the United States decreased by about 12.3 percent during the same period.

Utilization rates were highest for Medicaid enrollees (81.0 visits per 100 persons) and lowest for patients with private insurance (21.5 visits per 100 persons). + At 14.2 percent of visits, patients arrived at the ED by ambulance, representing over 16 million ambulance transports. + The mean waiting time to see a physician was 46.5 minutes.

Injury, poisoning, and adverse effects of medical treatment accounted for 35.3 percent of ED visits. Falls, being struck by or striking against, and motor vehicle traffic incidents were the leading causes of injuries presenting to the ED, accounting for about 41 percent of such visits. + 1.7 million visits were for adverse effects of medical treatment.
+ About 15.8 million ED visits resulted in hospital admission, representing 13.9 percent of visits. + After increasing for 10 years, the percentage of visits with no followup planned decreased to 6.3 percent. + Over 2 million patients were transferred to other facilities (1.9 percent of visits), and 317,000 patients either were dead on arrival or died in the ED.


Emergency Room Care becomes more necessary with every Season, but the Emergency Rooms are closing down. Almost 40% of ER visits would be hard to treat by other means. Ambulance Calls to Doctors' Offices and Clinics stands as the leading User of ambulance services. A Third of such ER visits are made by Patients who are insured, and likely to have a Private Care physician. Emergency Rooms are the sole Care-Giver for an estimated 20% of all Americans. ER crowding is becoming endemic. The Situation must be corrected, but How?

Plan of Action:
1) Separate Emergency Rooms from Hospitals and other medical facilities.
2) Have ER's maintain their own ambulance and Switchboard Service.
3) Fully staff the Walk-In Service (provide more Staff than simple ambulance reception)
4) Make ER's maintain their own Billing and Payments Dept.
5) Cease Government funding of Hospitals, restricting such aid to Emergency Rooms.

Emergency Rooms must become full-service Clinics. lgl

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