Two-thirds of Local Emergency Department Cases Could Be Treated Elsewhere, Avoided Altogether

A recent Dallas-Fort Worth Hospital Council report underscores how local emergency departments are being jammed by cases that either could be treated elsewhere or avoided by proper primary care.

The most common conditions treated in local EDs were low-back pain; painful or aching joints; chronic bronchitis, and asthma. More than two out of three cases—other than asthma—either were not emergencies or could have been treated in a primary-care setting. Nearly all of the asthma cases were emergencies that could have been avoided with proper primary care, according to the report, which was released in May.

Charges for ED visits are as much as seven times greater than those at primary-care clinics. The cost savings of as much as 85 percent represent a huge opportunity for cost-efficient care. Moreover, hospitals are not adequately reimbursed by Medicaid and Medicare—and rarely paid by uninsured patients—for the services provided.

One factor for preventable conditions is the lack of primary-care providers. According to the report, the Dallas metropolitan area needs 30 percent more physicians to meet the current demand. That gap is expected to rise to 50 percent by 2016. The report projects a population increase of nearly 10 percent for Dallas, Denton, Ellis, Fannin, Grayson, Kaufman, Navarro, and Rockwall counties.

The need for children’s medical services is even more dire, with current pediatric needs 80 percent greater than physician supply.

Children’s Medical Center is hoping to provide some relief by opening three of its MyChildren’s pediatric centers in neighborhoods where families are using the hospital’s ED for primary care.

And although Fort Worth was not included in the Hospital Council report, Texas Health Resources is preparing for rising demand. Harris Methodist Hospital Fort Worth broke ground May 30 on a $57.7 million ED that will be nearly triple the size of its current facility and contain 50 percent more beds. John Peter Smith Hospital also recently reorganized its ED to increase capacity.

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