Jul

17

We had a recent debate on the economics of medicine that — unfortunately– veered over into the realm of politics. I hope these facts will be considered solely as a question of how the business of medicine has evolved recently for hospitals:

According to the NEJM ED (emergency department) visit rates increased by more than a third between 1997 and 2007…The number of hospital admissions increased by 15.0%, from 34.3 million in 1993 to 39.5 million in 2006; admissions from the ED increased by 50.4%, from 11.5 million to 17.3 million.

The proportion of all inpatient stays involving admission from the ED increased from 33.5 to 43.8%.EDs have become the primary growth area for what all hospitals must have in order to make money - a supply of patients who stay for more than 1 night and have a major procedure.

Jeff Watson writes: 

I suspect the hospitals realize Stefan's observation. All around my town, Doctor's Hospital has billboards up with a real time wait numeric display for the wait time of the emergency room posted. If they say that the ER an 11 minute wait, a 2 minute wait, or a 30 minute wait, and they advertise this all over town, is it really an emergency room? FWIW, they also have smart phone apps doing the same thing.

Dan Grossman writes: 

I doubt anyone who has received or seen a hospital emergency room bill in recent years would regard it as a loss leader.

It is a mystery to me why Medicaid, Medicare and other programs do not encourage patients to go, if possible, to one of those for-proftt medi-quick clinics for a $150 bill, instead of to a hospital emergency room for a $1,500 bill.

Bud Conrad writes: 

I fell off my bicycle. (In Calf.)

I was strapped to a board and taken against my will to the Stanford hospital where I was in a neck brace for hours and was X rayed. Cat scanned and get this: given a sonogram! I guess they thought I might be pregnant. The 10 minute ride to the hospital was $1500 the emergency room about $15,000, and a couple of days later in a different hospital the surgery for a broken arm was $103,000 - not including the doctor, anesthesiologist, nurse or follow up care.

This system is broken beyond repair and a disgrace. From my point of view a POX on the whole lot of doctors, lawyers and government sponsored payments system!


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