Num­bers don’t tell whole story on ED care

Modern Healthcare - - COMMENT -

As a sub­scriber, I re­spect Mod­ern Health­care greatly. It con­sis­tently of­fers in­sight­ful and cur­rent in­for­ma­tion. As some­one who has worked in the emer­gency medicine in­dus­try for many years, I’d like to of­fer a dif­fer­ent per­spec­tive to your pub­li­ca­tion’s por­trayal of emer­gency care than the one pre­sented on the July 28 Data Points page (“The high cost of ED care,” p. 34).

Re­gard­ing the “23% in­crease in ED vis­its be­tween 2000 and 2010,” cer­tainly there has been a well-doc­u­mented in­crease in ED vis­its. How­ever, there are nu­mer­ous and com­plex rea­sons for the in­crease, not the least of which is the pri­mary- care short­age. Also, it is risky to sim­ply link cost with ED visit vol­ume.

About “Time taken in the ED for 25% of pa­tients— less than 15 min­utes.” A very valid rea­son for this is be­cause emer­gency physi­cians are known as “mas­ter di­ag­nos­ti­cians.” Per­haps this is truly an in­di­ca­tion of the ef­fi­ciency of our EDs.

About the “$9.2 bil­lion for falls, mo­tor ve­hi­cle ac­ci­dents and poi­son­ing,” I know of no bet­ter place than an ED to go for any of these pa­tient sce­nar­ios.

Fi­nally, the “13.3% of ED vis­its re­sult­ing in hos­pi­tal ad­mis­sions” misses the point that up­ward of 75% of all hos­pi­tal ad­mis­sions come via the ED. These physi­cians re­ally do see and treat the most se­verely ill and in­jured pa­tients. Emer­gency de­part­ments are not the cause of our health­care sys­tem’s prob­lems. Many call our EDs the “safety net” of the sys­tem; in many ways our EDs are the only net of the sys­tem.

John G. Hol­stein Direc­tor Zotec Part­ners Bala Cyn­wyd, Pa.

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