9 patients made nearly 2,700 ER visits in Texas

[Tab]

Source: Associated Press

AUSTIN, Texas – Just nine people accounted for nearly 2,700 of the emergency room visits in the Austin area during the past six years at a cost of $3 million to taxpayers and others, according to a report. The patients went to hospital emergency rooms 2,678 times from 2003 through 2008, said the report from the nonprofit Integrated Care Collaboration, a group of health care providers who care for low-income and uninsured patients.

"What we're really trying to do is find out who's using our emergency rooms ... and find solutions," said Ann Kitchen, executive director of the group, which presented the report last week to the Travis County Healthcare District board.

The average emergency room visit costs $1,000. Hospitals and taxpayers paid the bill through government programs such as Medicare and Medicaid, Kitchen said.

Eight of the nine patients have drug abuse problems, seven were diagnosed with mental health issues and three were homeless. Five are women whose average age is 40, and four are men whose average age is 50, the report said, the Austin American-Statesman reported Wednesday.

"It's a pretty significant issue," said Dr. Christopher Ziebell, chief of the emergency department at University Medical Center at Brackenridge, which has the busiest ERs in the area.

Solutions include referring some frequent users to mental health programs or primary care doctors for future care, Ziebell said.

"They have a variety of complaints," he said. With mental illness, "a lot of anxiety manifests as chest pain."

Read more: http://news.yahoo.com/s/ap/20090401/ap_on_re_us/frequent_er_patients

[Barack_America]

1. Our denial of mental health needs and services costs us dearly.

And will continue to do so until we deal with it.

[Tab]

2. If I did the math right

That's going there once a week (averaged).

[XemaSab]

6. 50 visits a year for 6 years, yes

x(

[Javaman]

27. Everyone needs a hobby, sadly it's at our expense. nt

[sofa king]

32. Yes, it's a shame Saint Ronnie made it okay to ignore such people.

We'd still be paying for it, but at least a mental home would provide a roof, a controlled environment, and on-site medical facilities.

And every single person who reads this would want the same thing if they knew someone who was homeless and/or had psychological issues. But because we can pretend the problem doesn't exist, it only shows up on the bottom line.

[Javaman]

37. I think you took my comment the wrong way.

I wasn't condemning these people at all. moron ray-gun destroyed what was a very good mental health system in this nation. and as such, people have to go back time and time again to get the help they need. as a result the expense is passed on to the average person, where as if we had a good mental health system in this nation, these people would get the help they need and wouldn't drive up health care costs for the rest of us. But sadly, the system is gamed and set up so the insurance companies are the only winner. We lose in higher health care costs, and the homeless lose by getting inadequate health care.

[sofa king]

41. We agree completely.

Just to be clear, my comment above wasn't directed at you, and I'm sorry if you read it that way.

No, it was just the usual bitterness I have for the conservative revolution that so very nearly destroyed this nation. I'm sorry that bled out on you.

[Javaman]

42. No probs, it's all good. :)

peace.

[Turbineguy]

3. 3 million, 9 people, 6 years

They could have been provided with insurance for less than $55,500 each per year?

We need more republicans to help with these sorts of problems. Anyway the homeless like fresh air, right?

[Traveling_Home]

7. I think they had insurance - most people with severe ...

Mental Illness are on either Medicare or Medicaid.

I think this is a lack of consumer oriented resources not a lack of insurance.

[rainbow4321]

15. Assuming they are in the "system"

If they have never applied for either, they may be in the "falling thru the cracks" crowd who just show up in an Emergency Room.


Speaking of mental illness and the homeless population:
Saddest thing I saw today while waiting for my bus after work (in front of the our county hospital). An elderly man, looked ragged/unkept/perhaps homeless, on his knees in the grass next to the bus stop plucking blades of grass/surrounding scraps of trash up and throwing them in the trash can... he repeated the steps over and over and over. Then he just stopped and wandered down the sidewalk.
We have quite a few in that area, last one I saw was an elderly woman having a heated, curse-laced, LOUD conversation with no one...in her mind I guess SOMEone was in front of her as she stood on the side of the road but there was no one there. My fear was that whatever images she had in her mind would make her wander into oncoming traffic.
It's people like this that make me say that the patients who showed up in the ER may not have applied for Medicaid, etc... and have no one to help them access the system.

[Traveling_Home]

21. The hospitals ALL have Social Workers in Emergency and Admissions whose only job is to make sure ...

such folks don't end up falling through the cracks and cost the hospital money. They complete the application forms and insure the insurance!!

That's just the way it works.

I would be very surprised if the person you saw today didn't have benefits. Probably at some shelter that at least sees they have a meal when they need it.

[rocktivity]

4. That averages out to nearly one visit per week per patient!

Oh, wait--it's April Fools' Day...

:crazy:
rocktivity

[Tab]

5. I don't think this one is an AF joke...

Sadly, it's probably real. And it wouldn't be that funny anyway.

I'm sure there are 9 people in Austin that probably drop into the ER every week. Hospitals are required to treat people, insurance or not, the full-paying folk underwrite the underinsured, and everyone's encouraged to "go to the emergency room".

When I grew up, the emergency room was if you cut your arm off with a chainsaw. Now it's used as a regular doctoral clinic, even if you just have the sniffles, and for the poor, it's just where they go, yet it racks up costs at emergency room prices.

What hospitals need to do are spin off low-end clinics where you can get treatment for minor ailments, at reduced charging, and free up the emergency room for actual, um, emergencies.

However, from a hospital point of view, if they can charge an emergency room rate for a sniffle, or spread it across patients, there's no incentive to cut down that income generator.

In other words, this is just another sign of how the system is broke.

[jmowreader]

16. The low-end clinics wouldn't solve the indigent problem

The only place in the hospital where the government requires them to treat anyone who walks in without ability to pay is the emergency room. People don't generally bring nonemergency cases to the ER if they can afford to have them treated somewhere else, and the low-end clinics would definitely charge.

[bluestateguy]

8. Got hypochondria?

Geesh.

[aquart]

14. Reading issues?

[slampoet]

26. Jeez you didn't even frikkin read the article.

Next time you want to post........don't

[phantom power]

9. We could give them proper health care...

so they don't have to use the fucking ER as a surrogate doctor's office.

But no amount of waste is too much to avoid Teh Socializm!
:eyes:

[GreenPartyVoter]

11. Nail, meet hammer.

[Ex Lurker]

18. I agree, however not having a primary care physician is pretty far down

the list of these people's problems. Think serious mental illness and/or drug addiction. Set them up with a free or nearly free doctor available by appointment and I'll bet they'd STILL show up in the ER. Dealing with people like this is what makes veteran ER personnel as cynical as cops.

[phantom power]

22. Perhaps in these cases, it would be more like...

"proper mental care" and/or "proper addiction treatment" ?

At any rate, in a really good system, all such services would be socialized and fully available, along with physical health care. It's not my field, but if they're so disfunctional that they're wandering into the ER on a regular basis, then they would be best off with proper supervision.

[Ex Lurker]

23. I agree n/t

[readmoreoften]

10. Another point: what they received was not $3 million dollars "worth" of services

but rather 2700 instances of service that were billed out as $3m for the purpose of profit. If I think I'm having a heart attack, it does not cost much for a doctor to determine this. It does if the cost of every item is billed at 10x the actual cost in order to make a surplus profit off someone's else's need for medical attention.

[bemildred]

12. Or we could just treat is as a public utility.

And not focus in a pejorative way on those citizens that happen to need it most.

[aquart]

13. Or it was the only way they could get human contact.

[rainbow4321]

19. May very well be the case

I work in an outpatient clinic at a county hospital and I've had at least one patient tell me that he enjoyed coming to the clinic because sitting in our waiting room allowed him to socialize. Others seem to be in the building as many days a week as we employees are.

We've been known to let more than one known homeless person sleep in the waiting room chair or in one of our back rooms because we know once our building closes, they are back out on the street for the rest of the night. Many have mental illness or drug abuse issues that keep them from being allowed to enter/stay at a homeless shelter--or for whatever reason, they just don't want to go to one.

[aquart]

24. To be homeless is to be someone no one will look in the eye.

The loneliness must be soul scorching.

[bertman]

17. I have a friend whose close relative is a crack head and alcoholic who suffers from

emphysema or some similar lung disease and has heart trouble and about everything else. The man is 60. He's been doing these drugs and the alcohol for at least 30 years. He's been admitted to the hospital at least six times in the last two years with life-threatening emergencies. Every time he is released he goes right back on the street and starts all over again. His children have tried to get him to quit. They have taken him in numerous times but had to put him out because he was doing drugs in their homes where their children are. His sister is his enabler who gets his SS check and provides him with a place to sleep.

According to my friend, he just doesn't give a damn what anyone else thinks or what anyone else wants him to do. He tells them to mind their own business and stay out of his. All of his adult life he has proclaimed how proud he is that he has paid very few taxes and lived the way HE wants to live. Yet he goes to the emergency room and gets free treatment whenever he's in a bind. The doctors have called in his children to tell them that he has these drugs in his system. They just laugh and tell the doctors "we know this. He has been doing this for his adult life and he's proud of it. We've tried to help him but he doesn't want our help, but please feel free to do what you can." So far no one has been able to do anything.

On numerous occasions while he was recovering from his medical problems he has been kept in the hospital long enough to detox his body. Every time he gets out the first thing he does is go get his money from his sister, go get a hooker, go get fucked up again.

Some people just want it THEIR way no matter what the price is.

[Historic NY]

20. They go to ER's because they are open 24hrs, mostly it not for a medical problem either..

I've seen it many times in my former career.

[No Elephants]

25. Could this be fraud on the part of the facility?

[AngryAmish]

28. This reminds me of where getting apartments for the homeless is a cheaper solution

I forget where I read this but in some places the hardcore homeless are given apartments for free. They can drink and do drugs all they want. Small, cheap flops. Why? Cheaper than services for when they are on the street.

There is a moral hazard problem but cheaper is cheaper.

[maxsolomon]

33. Seattle has an apartment building just for chronic alcoholics

no requirement to be in a detox program, however, that is available should any of them WTFU.

the building cost & maintenance is much cheaper than the emergency services this population regularly uses when on the street.

plus, dignity.

[AngryAmish]

38. I think that is the program I was thnking of.

[maxsolomon]

40. i think it has turned out to be an unmitigated success

http://www.google.com/hostednews/ap/article/ALeqM5iRUMBkWbcZFto1v6IW6k64mdEbSQD9798JOG0

i do notice fewer stumbling drunks downtown.

but they've been replaced by crackheads and tweakers and schizos. yay seattle!

[w8liftinglady]

29. this happens a LOT at my hospital

Believe it or not,many times it is people in SNFs...the usual diagnosis-chest pain,chf.It may have to do with the human contact thing,like you said.Their family flocks around them in the hospital.

[excess_3]

30. this is the future of medicine

hanging around near hospitals,
is, unfortunately,
a very popular hobby

[The Stranger]

31. Someone is making a lot of money off of admitting and re-admitting patients they know don't need it.

At the taxpayer's expense.

[maxsolomon]

34. i don't know that the law gives them much of a choice in the matter

do you?

[The Stranger]

35. But that's just it.

They have carte blanche to run up a massive bill, even if the issue is not life-threatening, and then stick the tax payers with the bill.

[underpants]

36. Yes this smacks of fraud.

The Frist family's HCA has been busted committing about $8 Billion in Medicaid/Medicare fraud over the years, that was what they were CAUGHT doing.

[Hugin]

39. So, our worst-of-all-worlds for-profit Healthcare System failed those 9 people?

No surprise.

You'd think on the second or third visit they would have referred them to someone who could treat their obvious problems.

Oh, wait! There is no Emergency Mental Healthcare since Reagan.

:fail: