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View Diary: Abbreviated Pundit Round-up: More on ACA and Oregon ERs (109 comments)

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  •  I highly rec Austin Frakt link on Oregon Medicaid (8+ / 0-)
    It may also be the case that the ED is less interested in the “whole patient,” treating just the symptoms as presented. Some consumers may view this as an advantage.
    His list of why unhealthy poor people who've not had access might go to Emergency first, reminds us that there is a large human behavior component. Their website is one of few trying to approach American health care from a scientific perspective and seeking improvements across the system.
    •  it's a great series and so is this link from there (6+ / 0-)

      to another great site, this by Harold Pollack.

      Medicaid – and what having it means to ERs

      Three-year study of low-income adults produces some heartening and not-so-heartening findings about impact of Medicaid enrollment

      "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

      by Greg Dworkin on Sat Jan 04, 2014 at 05:24:47 AM PST

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    •  and since you liked the austin frakt piece (4+ / 0-)
      MT @DemFromCT: Patients are smarter than we are. http://t.co/...
      @afrakt

      "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

      by Greg Dworkin on Sat Jan 04, 2014 at 06:17:01 AM PST

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    •  I think a surge is understandable (1+ / 0-)
      Recommended by:
      rl en france

      I mean all these people weren't insured before, when they got it they decided to do something about their health problems.
      they were saying on the news last night here in OR that the results were inconclusive

      Happy just to be alive

      by exlrrp on Sat Jan 04, 2014 at 06:23:35 AM PST

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      •  see the sarah kliff piece (3+ / 0-)

        the Oregon data is now 5 years old. She has an update.

        "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

        by Greg Dworkin on Sat Jan 04, 2014 at 06:31:04 AM PST

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        •  did you see this 2013 study (2+ / 0-)
          Recommended by:
          Heart of the Rockies, mikeVA

          from RAND?  

          The Evolving Role of Emergency Departments in the United States

          • Between 2003 and 2009, inpatient admissions to U.S. hospitals grew at a slower rate than the population overall. However, nearly all of the growth in admissions was due to a 17 percent increase in unscheduled inpatient admissions from EDs. This growth in ED
          admissions more than offset a 10 percent decrease in admissions from doctors’ offices and other outpatient settings. This pattern suggests that office-based physicians are directing to EDs some of the patients they previously admitted to the hospital.
          •  In addition to serving as an increasingly important portal of hospital admissions, EDs support primary care practices by performing complex diagnostic workups and handling overflow, after-hours, and weekend demand for care. Almost all of the physicians we interviewed—specialist and primary care alike—confirmed that office-based physicians increasingly rely on EDs to evaluate complex patients with potentially serious problems, rather than managing these patient themselves.
          •  absolutely true (0+ / 0-)

            and ACEP and other ER specialists have pointed this out for years. Especially true after hours if there is no alternative.

            But in that time frame (and the preceding years), "elective" admissions have dropped. No more overnights for tonsillectomy, or even same days. So naturally, % from ER, the portal, has gone up somewhat. All blends together.

            "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

            by Greg Dworkin on Sat Jan 04, 2014 at 07:26:06 AM PST

            [ Parent ]

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