NCPA - National Center for Policy Analysis

Emergency Rooms Turn Away Non-Emergency Patients

April 28, 2004

For decades hospital emergency departments have accepted thousands of non-urgent cases and swallowed the cost. That is starting to change. University of Colorado Hospital is leading the way with a controversial solution: weeding out non-emergency cases so it can treat serious, life-threatening traumas.

Its system of medical screening, or triage, could help ease financial strains that have shut down many hospitals ERs in the last decade. Under the new policy, the hospital demands partial payment up front from non-emergency patients who seek treatment in the ER. For Medicare and Medicaid beneficiaries, the fee is a small cash copayment. For the uninsured, the charge can be a few hundred dollars -- causing many of them to opt for a low-cost clinic in the area.

  • A record number of patients are flooding emergency rooms, and in 2002, U.S. hospitals provided $22.3 billion in uncompensated care, up from $18.5 billion in 1997.
  • One-third of the care provided in U.S. emergency departments is "inappropriate" -- for instance, at a Houston health care system non-urgent complains accounted for 120,000 out of 345,000 ER visits.
  • At University of Colorado Hospital, rashes and allergies are precisely the sort of cases that used to jam the emergency department -- in the past six months, ambulances have delivered three hangnail cases to the ER; another person made 165 visits in one year.

Experts say ER care is both the most costly and least effective way to deliver treatment for the chronic problems that claim the greatest number of lives each year.

Source: Ceci Connolly, "Some Finding No Room at the ER; Screening Out Non-Urgent Cases Stirs Controversy," Washington Post, April 26, 2004.


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