Please answer following questions for case provided
below:
1) Why do patients who are not critically ill go to emergency
department?
2) Why do the variety of services emergency department produce
and the amount of overhead to be allocated make cost finding
difficult.
3) Why was Morgan confident that cots could be reduced while
quality could be improved? Is this conclusion supported in the
literature?
4) Thinking as a consumer, what would constitute higher
quality in the emergency department?
5) What options should the hospital consider? Why would you be
confident that these options would incur lower costs than an
emergency department? Do you think quality would be higher?
6) If the hospital creates one or more urgent care clinics and
adds evening and weekend hours to its primary care clinics, what
will happen to emergency department volumes? What effect wills that
have on emergency department costs?
A Colorado woman took her daughters to what she thought was an
ur- gent care clinic in a shopping mall (Olinger 2015). Both were
treated for respiratory problems, and the visit went well. “I
thought it was a fine experience,” she commented, “until I got the
bill.” She had gotten care from a free-standing emergency
department, not an urgent care clinic, and her out-of-pocket
obligation for the visits was nearly $5,000. This represents an
unusually high price, but care is expensive in emer- gency
departments. Ho and colleagues (2017) found that treating respi-
ratory infections in a hospital's emergency department averaged
$1,074, and treating respiratory infections in a free-standing
emergency depart- ment averaged $1,351. In contrast, treating
respiratory infections in an ur- gent care center averaged $165.
(These are average prices paid, not charges.) Prices in emergency
departments are typically more than ten times those in urgent care
clinics. These high prices explain why many healthcare reform plans
seek to steer patients away from using emergency departments. For
example, Oregon moved most Medicaid enrollees into coordinated care
organi- zations, with the explicit goal of reducing emergency
department use (McConnell 2016). (Because they have difficulty
accessing other sources
of outpatient care and because they face low out-of-pocket
costs, Med- icaid enrollees tend to use emergency departments at
high rates.) In Ore- gon, use of emergency departments fell by 8
percent (McConnell 2016). About a third of emergency department
visits are not emergencies, and there is an ongoing controversy
about how much such a visit costs (Galarraga and Pines 2016).
Perspective differences cause part of the con- troversy. Insurers
and patients talk about the prices that they pay, and providers
talk about how much it costs to produce such visits. Yet an- other
perspective notes that patients who use emergency departments as
usual sources of care have high rates of preventable
hospitalizations. Galarraga and Pines (2016) estimate that the
average payment for a visit that is not an emergency is $883 but
the average payment for a pre- ventable hospitalization is
$9,515.