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1996-01-01
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MCL Extra
Bottom Line Better, Care?
Continuing our NewsCenter 5 series, we present HMO's and
Emergency Rooms--Part II:
Changes in health care are bringing big changes to hospital
emergency rooms.
Some HMO patients have discovered their health plans won't always
cover emergency room visits.
But some E-R staffers say the changes HMOs have brought . . . are
for the better.
"Why don't you come here, I'm going to have a look at that
hand."
At Winchester Community Hospital, the evolution of managed care has
been welcomed by the emergency room staff. They see fewer patients
with sore throats and twisted ankles, allowing them to focus on the
more serious injuries.
Joanne Dyson (Winchester Hospital):
"Two or three years ago we saw some unhappy patients who were
upset we were asking them for approval of this visit by their
primary care physician. Now we find patients come and fully
expect to be asked and even are volunteering information."
HMO's keep tight control over expensive ER visits . . . and
Emergency Department visits are down 70% among HMO members.
Dr. Michael Martin (Fallon Community Health Care):
"I also think there is a huge overuse in ER visits. 40-60% are
non-urgent visits."
But talk to ER doctors and you find concern . . . that patients who
should be treated in the ER are being sent to a doctor's office.
Dr. Charlotte Yeh (New England Medical Center):
"It's not always clear that the primary care providers are in
fact capable of doing it. Not because of intent, but because
they haven't had the time to come up to speed."
Dr. Richard Swartzstein (Beth Israel Hospital):
"It's fraudulent to say we're going to cut the cost of health
care and not impact the way you receive care."
HMO's say the alternative to the ER is the urgent care center . . .
staffed by former emergency room doctors. Fallon Community Health
say its staff has an advantage over the ER when handling
non-lifethreatening cases . . .
Dr. Michael Martin:
"We have access to patient records, x-rays, pharmacy use, drug
allergies."
So doctors don't have to do full workups on every patient or order
as many expensive medical tests. For a visit here . . . $90 . . .
compared to $400 for an average trip to the ER.
The bottom line is clearly better. The debate: is the care as good?
[This report from medical reporter Heather Kahn aired 15-Nov-1995.]
...For further information, contact CURE, 812 Stephen St., Berkeley
Springs, WV 25411. 304-258-LIFE/258-5433 (CUREltd@ix.netcom.com)