By Ebony Tinsley A trip to the emergency room can be an expensive nightmare for households. It is a place that is often filled with frustrated patients and their relatives who feel vulnerable and neglected. While the emergency room is designed for those who are suffering serious and unexpected medical conditions, there are more non-urgent emergencies using these services every day. Forty percent of emergency patients were non-urgent in 2012. Moreover, the hospital emergency department is the only facet of the health care system required by federal law to provide care to all patients, regardless of ability to pay. This means a clinician must prioritize patients, which contributes to the overall frustration in the emergency room. Many poor and working class people use the emergency room for primary care due to lack of education about medical care. Emergency medicine can be divided into roughly two broad areas: pre-institutional care and institutional care. Most people associate the institutional aspect with emergency departments. However it also includes other areas such as urgent care facilities and specialized facilities like shock and trauma centers. Peter Nicks, an Emmy award winning producer, released a documentary focused on the local county hospital, Highland Hospital in Oakland. The documentary focused primarily on healthcare policy and uninsured patients who often wait from one to 14 hours for care in a room packed with others waiting to be seen. This Emergency Department overcrowding strains the limited resources of hospitals like Highland. Debates about who uses Emergency Department Resources are common in the medical field While people with private insurance account for most emergency room use, non-urgent visits account for 10 percent;, most of which are paid by Medicaid. Non-elderly adults with Medicaid generally have higher emergency use across the board. Interestingly enough, the primary diagnoses of emergency patients with Medicaid ages 21-64 were digestive diseases and urogenital diseases. So what is causing the disparity in views and healthcare among Medicaid patientsand private insurance patients? Urgent patients are prioritized in two ways –whether their injury is internal or external and how the injury occurred, which determines treatment. If judged to be medical (non-urgent), the clinician searches for the force or condition responsible. This type of assessment requires quick thinking. Fifty percent of Medicaid and private insurance patients were categorized as urgent. The problem, however, is that a full physical exam is not included during rapid assessment. Many patients have the potential to be categorized incorrectly as a result. The Medicaid program solution increases patient cost sharing to discourage patients from using Emergency services. This penalizes Medicaid patients who use Emergency Departments for primary care. Future work should focus on creating access to adequate healthcare for poor and working class communities. Facilities like the James A Watson Wellness Center work towards this goal by providing primary care in the treatment of prevalent diseases such as hypertension, cardiac disease, diabetes, HIV, and cancer. The James A. Watson Center believes that access to preventative care programs must be available to not only the wealthy and affluent but also to the needy and underserved.
The Emergency Room: Urgent Care or Primary Care?”
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