(U. of C.) Program links uninsured patients to clinics

Reply Sat 8 Jul, 2006 09:11 am
From today's Chicago Tribune, section 2, pages 1,2:

U. of C. tries new approach to uninsured

Non-emergency visits run up hospital costs

By Bruce Japsen Tribune staff reporter

Known around the world for teaching the latest medicine and conducting cutting edge research, the University of Chicago Hospitals is taking on yet another mission: educate the uninsured on how to get quality medical care without showing up in its expensive emergency room.

In any hospital, the emergency room is typically the priciest setting for care. But at an academic center like University of Chicago, it can be 60 percent more expensive than it would be at a community hospital because teaching facilities also train future doctors and conduct research.

So when patients like James Kinney end up in the U. of C. emergency room for a pulled muscle, which could have been treated at a nearby clinic or community hospital for a fraction of the price, it adds a staggering amount to everybody's health-care costs.

Kinney, a 64-year-old uninsured electrician, came to the hospital when he developed excruciating pain in his hip. He was treated but also referred to a new program to help him get follow-up care and develop a relationship with other doctors and clinics.

"I was not aware of where else I could go," Kinney said. "I could hardly take the pain."

Kinney is like millions of Americans across the country who unwittingly turn to the hospital emergency room because they don't know their options, don't have insurance or are overwhelmed by a health-care system that has difficulty explaining how it all works.

A clinic visit might cost $100, while an emergency room stop costs about $1,200, most of which is absorbed by the hospital. Extrapolated across more than 200 of the nation's major academic medical centers and thousands of similar experiences at each facility each year, costs for treating patients in teaching hospital emergency rooms easily runs into billions of dollars a year, these hospitals say.

Rather than blame the thousands of uninsured patients, the hospital is taking a unique approach: Employees in its emergency room are educating their patients after treatment begins.

In University of Chicago's "Healthy Community Access Program," staff at the emergency room link patients to a primary-care doctor often closer to their home. They even have the ability to schedule follow-up appointments in designated slots at affiliated clinics.

The idea is for the patient to avoid a long emergency room wait while at the same time find a "medical home" so they get regular, preventive care that can be handled by dozens of other outpatient options more quickly, effectively and closer to their home. Staff members are on duty between 8 a.m. and 11 p.m. daily, and the hospital hopes to expand the service to 24 hours.
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Full online report: U. of C. tries new approach to uninsured
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Reply Sat 8 Jul, 2006 11:29 am
Education makes good economic sense.

Blue Cross/Blue Shield companies are finding that their 24 hour "Call Blue" hotline (staffed by computer savvy registered nurses) is saving a lot of money.
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Reply Sat 8 Jul, 2006 12:19 pm
I also welcome this idea. Having no health insurance can be financially very
devastating should an emergency arise. Educating these poor people
about various options is a step into the right direction, for both parties involved - the hospitals and the patients.

I hope this procedure will be soon available in hospitals across the nation,
and especially here in southern California, where the influx of undocumented workers towards emergency rooms is very prevalent.
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Reply Sat 8 Jul, 2006 06:35 pm
Happens even here, where there is universal health insurance, because many doctors' clinics charge a gap (though a small one for poor people, or none) and, in the areas where poor families mostly reside, there is a scarcity of doctors.

Where I live, I can get into see a doctor usually the same day.

Where I used to work, which was in poor family land, it might take two weeks (and I mainly used the doctor near work, because that's where I seemed to be in doctor's hours.)

Oddly, my doctors' locum service, which comes out to your home after hours, with a doctor AND a driver (I had to call it when I got a serious infection) charged no gap. Weird.

Hospital ERs here are setting up GP practices within the ER setting to try to deal with the problem.

What Walter posted about sounds a great idea!
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Reply Sun 9 Jul, 2006 02:07 pm
Once upon a time the local pharmacist used to function as a combination First Aid Expert and Triage Nurse.

Once upon a time before good will became a dangerous commodity.
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