Emergency Room Overutilization Essay

Emergency Room Overutilization Essay

Length: 1779 words (5.1 double-spaced pages)

Rating: Powerful Essays

Open Document

Essay Preview

Emergency room over utilization is one of the leading causes of today’s ever increasing healthcare costs. The majority of the patients seen in emergency rooms across the nation are Medicaid recipients, for non-emergent reasons. The federal government initiated Medicaid Managed Care programs to offer better healthcare delivery, adequately compensate providers and reduce healthcare costs. Has Medicaid Managed Care addressed the issues and solved the problem? The answer is ‘Yes’ and ‘No’.

Throughout the early 1980’s and 1990’s the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing number of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the over utilization of hospital emergency rooms. This is a direct result of not having a primary care physician and/or family doctor who is the main source of healthcare delivery for an individual and/or entire family The traditional Medicaid program does not offer, or require, recipients to choose a primary care physician like, its counterpart, Medicare. Medicare still operates under the traditional fee-for-service methodology and does not require beneficiaries to identify and primary provider as well as having direct access to specialty services. This allows a cost sharing approach which results in higher out-of-pocket expenses and does not cover drug or prescription benefits.

In an effort to offer better healthcare services and access as well as reduce costs the federal government allowed the States to turn to managed care and proposed a mandatory statewide implementation for the Medicaid population. In order to make major changes like these, states have to request waivers of Medicaid regulatio...

... middle of paper ...

...sive.(Practice Trends)." Clinical Psychiatry News 33.2 (Feb 2005): 88(1). Academic OneFile. Thomson Gale. University of Phoenix. Retrieved February 25, 2013 from:

5. Roohan, Patrick J., Anarella, Joseph P., & Gesten, Foster C. (July-August 2004)
Quality oversight and improvement in Medicaid managed care.(Quality Assurance Reporting Requirements ). In Journal of Public Health Management and Practice, 10, p321(9).

6. Wang, Cheng, Villar, Maria Elena, Mulligan, Deborah A., & Hansen, Toran. (Nov 2005) Cost and utilization analysis of a Pediatric Emergency Department Diversion Project. In Pediatrics, 116, p1075(5). Retrieved July 11, 2013, from InfoTrac OneFile via Thomson Gale:

Need Writing Help?

Get feedback on grammar, clarity, concision and logic instantly.

Check your paper »

Emergency Room Physicians Essay

- ... To even be considered competitive you have to have at least an A average and get at least 35 out of 45 the average score is only a thirty(How to Become an ER Doctor). If you get into a medical school like at the same place you were to complete your under graduate classes then you won’t have that much of a change, but if you want to change school then it will be a bigger change. If you were to go to Stanford, which is one of the most prestigious university’s in America, then you would have a better chance at getting into a residency program....   [tags: emergency medicine, medical school]

Powerful Essays
1041 words (3 pages)

Emergency Room Overcrowding And Emergency Rooms Essay example

- Approximately half of a million Americans are homeless, living in shelters or living on the streets (Galea & Vlahov, 2002). The homeless population utilizes the emergency room to gain access to primary care, nutrition, pharmaceutical supplies and basic needs. The utilization of the emergency room with non-medical or non-emergent issues is contributing to emergency room overcrowding (Galea & Vlahov, 2002). These needs to be relocated out of the emergency room within the hospital so they can be easily obtained by the homeless population the hospital serves....   [tags: Sociology, Social work, Homelessness, Hospital]

Powerful Essays
1483 words (4.2 pages)

Essay on Emergency Medicine and Emergency Physicians

- Everyone dreads getting injured. When someone injures himself or is not feeling well, he goes to the emergency room (ER). While in tremendous pain, he is caught up in the chaos of the ER where he must wait, sometimes for hours, for an emergency physician. Emergency physicians try their best to help patients feel better, ordering numerous tests that help them determine what’s wrong. Eventually, patients all leave the hospital, feeling much better than when they came. Emergency Physicians provide primary care to a host of patients entering hospital ERs with illnesses and injuries covering a broad spectrum, from acute infections to life-threatening conditions....   [tags: er room, doctors]

Powerful Essays
852 words (2.4 pages)

Essay on Telemedicine Use In The Emergency Room

- ... Telemedicine is the use of bidirectional audio/video equipment to provide synchronous or asynchronous communication. Employing the use of the telemedicine equipment for a patient consultation is based on the right patient at the right time and it has the ability to drastically change a patient’s outcome. It is with this understanding that the choice to consult with a neurologist by way of the telemedicine equipment is the decision of the emergency room physician. It is the emergency room physician’s responsibility to initiate the neurology consultation by way of a phone call to the neurology group on call....   [tags: hospitals, pacients, training]

Powerful Essays
967 words (2.8 pages)

Essay on A Working On The Emergency Room

- A. Working in the emergency room I encounter many patients who come in for psychiatric evaluation, wither it is due to suicidal thoughts or depression. Through the constant training that our hospital puts on, I have learned how to better deal with these types of patients who can be difficult at times. I have learned that something as simple as listening to a patient and just hearing them talk can help to de-escalate whatever situation that person may be in. I have also learned how to better assess these patients and help provide them with other resources that are needed, like depression related support groups or counseling....   [tags: Hospital, Patient, Myocardial infarction, Illness]

Powerful Essays
981 words (2.8 pages)

Essay about The Emergency Room ( Er )

- Mondays in the emergency room (ER) are typically busy. Most of the patients contributing to this volume have dealt with a medical issue all weekend, cannot get into their primary care provider or both. Of course, there are the typical emergent patients that have no other choice but to be seen immediately, and they make up the rest of the volume. The aforementioned reasons often cause increased stress and frustration among these patients. So, as an emergency room nurse, it is understood that our encounters with patients might not be the best, as these people are probably not having their best day....   [tags: Health care provider, Patient, Hospital]

Powerful Essays
1391 words (4 pages)

Essay about The Safety Of The Emergency Room

- As I handed a blanket to a patient, the doors outside the room burst open. While this was a common occurrence in the emergency room, something felt extremely different this time. As the emergency medical technicians wheeled a patient in, she screamed in pain. Peering out of the room, I witnessed massive bruises and blood dripping down her face. Her clothes, tattered and torn apart, looked as if she was attacked by a beast. My heart broke for this woman, as the next phrase she screamed sent chills through my body....   [tags: Medicine, Physician, Health care, Pediatrics]

Powerful Essays
812 words (2.3 pages)

Physicians in the Emergency Room Essay

- Emergency room physicians see many incommensurable types of injuries everyday. The six most common injuries occurring in the ER are from trampolines, lawn mowers, playgrounds, swimming pool, bikes, and burns. These kinds of damage are all things that ER physicians could see on a daily basis. From acquiring all this knowledge, I have decided that I want to enter the field of medicine, as an emergency room physician. Granted that emergency room physician jobs are stressful, due to the fact that they are dealing with injured and upset people 24/7....   [tags: job description and salary]

Powerful Essays
941 words (2.7 pages)

Emergency Room ( Er ) Essay

- Emergency Room Emergency is defined as a serious situation that arises suddenly and threatens the life or welfare of a person or group of people. An emergency department (ED) or also known as emergency room (ER) is a department of a hospital concentrating in emergency medicine and is accountable for the delivery of medical and surgical care to patients arriving at the hospital needing an immediate care. Usually patients will arrive without prior appointment, either on their own or by an ambulance....   [tags: Hospital, Patient, Urgent care, Nursing]

Powerful Essays
948 words (2.7 pages)

The Emergency Room On Friday Essay

- There were a lot of patients that came into the emergency room on Friday November 20, 2015 that had heart problems. The first patient I observed was only thirty and she had been having tachycardia since two o’clock Thursday afternoon. She stated that she has had this problem before but it never lasted this long. She was said to have SVT prior to arriving to the emergency room by the ambulance crew. Upon arriving in the ER her heartrate got up to 220 beats per minutes. The next patient that I saw was brought in because his wife said that he was shaking more than usual, he had Parkinson’s....   [tags: Physician, Patient, Doctor, Hospital]

Powerful Essays
1295 words (3.7 pages)