Emergency room visits soar in Sonoma County under Obamacare
New state data shows
The 67-percent jump in ER visits by
"There's a serious disconnect between what society believes the function of the emergency department should be and what a large subset of our patients actually use it for," Ferrari said.
A visit to the nearest ER is also much more costly than seeking care at an urgent care center. One often cited study, funded in 2013 by the
In contrast, the cost of a visit to one of
Whether it's leading to emergency department overcrowding or adding to the overall cost of health care, medical professionals say the overuse of emergency departments affects everyone.
But county and state officials say aggressive measures taken to beef up the local primary care network and divert
Overall,
Ferrari said there have always been patients who use the emergency department "inappropriately" for conditions that could be treated in an urgent care or primary care setting. But he said there has been a significant uptick in recent years.
Countywide, emergency department visits by patients with private insurance and Medicare also increased between 2014 and 2016, but not nearly as significantly as it did for
Last year,
Ferrari said emergency doctors, nurses and other staff pay no attention to a patient's type of insurance -- they must care for anyone brought in, whether they walk through the doors or are brought in by ambulance on a gurney.
But Ferrari said such significant spikes in usage are a serious problem for everyone who relies on emergency beds, which he views as a "precious resource."
"The emergence of emergency department 'superusers' and people using the emergency department for minor complaints puts that resource at risk," he said.
Hospital officials said many of the newly insured under Obamacare are still not connected with a "medical home."
"We work on several fronts to get these individuals connected with a physician for their care needs and to encourage preventive care," said
"It is our belief that many newly enrolled
One of the key components of Obamacare was a significant expansion in eligibility for Medicaid. That expansion pulled 5 million people into the state's
That increase is the primary cause of the surge in emergency room visits, department spokesman
While the overall number of emergency visits by
He said state data also shows a dramatic decrease in the number of uninsured patients using emergency departments.
"Many of those previously uninsured are now covered by
In the long run, county and state health care officials said they hope unnecessary emergency room usage declines over time. The expansion of primary care offerings, particularly at local health centers, will be a key to making that trend a reality.
Cava said the state is working closely with managed care plans that administer
Initiatives include assigning all managed care enrollees to a primary care provider, such as a community health center, with an emphasis on getting new members to access preventative care. Managed care plans are also required to provide an initial health assessment for all new members, a step designed to establish a personal relationship between medical providers and their patients.
Cava said the long-term benefits of such managed care programs should reduce visits to emergency rooms, when appropriate.
The network of local community clinics, which is where most
The increase in primary care offerings by local clinics helped to reduce wait times for initial visits for new members, but more is needed, said
"What we've experienced in
That effort includes building more primary care and urgent care facilities, as well as hiring more primary care physicians, nurse practitioners and physician assistants.
Meanwhile,
"We know that prevention is way less expensive than emergency room costs," said
Partnership
About 37 of the 147 providers were hired in
Key to providing effective health care, she said, is educating members on the most appropriate use of the local health care system.
"There isn't a single solution to reducing the emergency room utilization," she said. "It requires strong collaboration with our community partners."
One patient seen earlier this month at
The patient, who is covered by
"He sat in a bed for three hours," Ferrari said. "That's time that somebody's sick kid couldn't get in, and the waits are going up and up and up."
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