Question

Please answer following questions for case provided below: 1) Why do patients who are not critically...

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.

Homework Answers

Answer #1

1. Patients who are not critically ill go to emergency department as emergency departments are easy to access whereas it is difficult to access other sources of outpatient care. Moreover, patients face low out-of-pocket costs in emergency departments which made them visit emergency departments.

2. The variety of services emergency department produce and the amount of overhead to be allocated make cost finding difficult as there is a controversy between Insurers, patients and service providers. Insurers and patients talk about the prices that they pay, and providers talk about how much it costs to produce such visits. Another reason behind this is that patients who use emergency departments as usual sources of care have high rates of preventable hospitalizations.

3. By reducing the operational cost over a period of time, costs could be reduced. This is attributed mainly to learning curve. As we go higher up and learn more about the process and short cuts, the operational cost can be reduced and at the same time quality could also be improved.

4. As a customer, higher quality in the emergency department constitutes the promptness of the medical representatives in taking the case quickly, availability of the qualified medical staff throughout the day and making the entire process hassle free so that the patient receives the treatment on time.

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