Wednesday, July 10, 2013

The ER is fine, thanks

Researchers at the Perelman School of Medicine at the University of Pennsylvania seem to confirm what I think--that low-income people are pretty good at looking out for Number One and many think they get a better shake at the Emergency Dept than the primary physician's office.

The study appears in the July Health Affairs.

The laughably named Affordable Care Act tries to improve ERs, but also make them be used less for routine matters. The opposite will happen.

For one thing, the system of making primaries provide referrals to specialists slows care down, is frustrating and stupid (I once had a primary say to come GET the referral, that their office "did not believe" in faxes).

Such systems drive canny types, such as those used to living by their wits in lieu of money, to say, hey, I can get a specialist at the ER if I need one. (That is sometimes doubtful, but it is the theory.)

Poorer patients use less preventive care--because of work-hour appts, copays, etc--so they are often sicker when they get sick.

The researchers interviewed 40 low-income patients in Philly.

They said often primaries don't provide the best care--they get impatient, stumped.

Also, if you factor in specialists, their share of costs, if they had a share, was less at the ER.

I often go to Urgent Care--I can go when I want, in, out. No weeks of waiting for an appointment. Not even that much waiting in the waiting room.

It is also very possible to go to a primary, then get SENT to the ER. So some people skip the middle step.

No comments: