ER's can earn hospitals revenue with ambulance deliveries

[Ridryder 911]

ER's can earn hospitals revenue with ambulance deliveries

U.S. hospital emergency rooms, frequently beset by too many patients and too few beds, can take in more money if they stop diverting arriving ambulances to other hospitals, a study on Wednesday said.

By putting in more beds and avoiding so-called ambulance diversion, a hospital could boost emergency-room revenues by 10 percent, according to the study of a 400-bed Oregon teaching hospital published in the Annals of Emergency Medicine.

"It's important that hospitals understand that decreasing ambulance diversion can translate into higher revenues," said John McConnell, who led the two-year study of his hospital's emergency room at Oregon Health and Sciences University.

Most emergency rooms are understaffed and overwhelmed with patients and unprepared to cope with a crisis such as a natural disaster or terrorist attack, the nonprofit Institute of Medicine said in a recent report. It also said diverting ambulances inevitably leads to unnecessary deaths.

But hospitals have been hesitant to add capacity because many emergency-room patients are among the ranks of the 46 million people who lack health insurance and may be unable to pay.

The new study is one of the first attempts to show the potential financial benefits to hospitals if they change course, the authors said.

U.S. hospital emergency room visits have risen steadily, jumping 26 percent between 1993 and 2003 to 114 million visits, according to the Institute of Medicine, which advises the government on health matters.

The Oregon study also found patients entering an emergency room by ambulance are less likely to be uninsured and more likely to be admitted to the hospital, than patients who walk in.

"That was a surprise to us," McConnell said. "The patients where a hospital makes a lot of money is the heart-attack (patient) who is then admitted," he said.

The Oregon hospital treats about 43,000 emergency-room patients each year, and midway through the studied increased bed capacity.

When beds were added and ambulance diversion dropped, the hospital gained about $175,000 in extra revenue per month.

A major limitation is the study didn't quantify the revenue lost from inpatient beds being used for emergency patients, Robert Williams of the University of Michigan School of Public Health said in an editorial in the journal.

"In simple economic terms, one patient is a sure thing and the other, a roll of the dice," Williams said.

Wow! It doesn't look like that study was too scientific, as well I don't know abut you guys, but most of my patients don't have insurance with or without ambulances, and most are NOT admitted into the hospital!

R/r 911

[Imagine89]

I can't at all believe that more pts brought in by ambulance have insurance...

[flight-lp]

Now that funny!!!!

[Just Plain Ruff]

They were kidding right, is it april fools day?

Add beds in the ER, means construction and disruption of the ER. This has to be more than the cost of putting a patient in a bed.

I don't see it.

Plus, if you have more patients than beds all the time then if you add more beds then you just put those patients in the additional beds. So if there is still more patietns than beds then where is the benefit???

[Scaramedic]

I think I can shed a little light on this study.

The hospital they are talking about is Oregon Health Sciences University. Up until about 1998 they had one of the smallest ED's in Portland. It was nestled in the back of the facility and was inadequate for a level 1 trauma center. I am not saying they were a bad ED, in fact they were a damn good ED, it was just too small. Being small and rather old they spent a lot of time on ED divert. They had one part of the ED with no air conditioning so when it got hot and busy they would break out the fans, yeah it was that bad. So in 1998 (if I remember right) they opened a huge and beautiful ED and they spent a lot less time on divert. So if I had to guess I bet they were using numbers that were pre-98 and post-98 in their study.

By the way OHSU has gone crazy with new construction. This is OHSU today....

Everything you see in that picture is OHSU. They have gotten so big they are building their Physicians buildings along the river and are building a sixty million dollar tram to connect the hospital to the new offices.

Peace,

Marty

:joker:

[Ridryder 911]

Wow!... Cost containment at its best!... Just to show, one can do wonders with statistics.!

R/r 911

[chbare]

I do not know what you guys are talking about. All of the patients that come to my er by EMS have insurance. "Self pay" is a form of insurance, right? :roll:

Take care,

chbare.

[paramedicmike]

You don't need new construction. Just put a conveyor system with cots so that each exam room can hold 5 or more patients. When you need to see a particular patient you just hit the button on the wall and wait for that cot to rotate around to the front (kinda' like at the dry cleaners). More people, less construction, more money, right? :roll:

-be safe

[tinman694]

I vote for the Disney approach...like the old "peoplemaker' in tomorrowland...Just a continuous flow of patients winding in a loop throughout the facility.

Speaking from experience...we have 3 hospitals in the immediate area who have 'increased' the size of each ED...( at least tripled their size and number of beds) They are still all just as full as ever--of mostly uninsured folks seeking primary care instead of getting it at a physicians office.

With my background in social science research, you can definitively make the numbers say whatever you want them to....Its not hard especially when you want that 450million dollar sleeper car tram system with a built in coffee bar and live entertainment....

(But don't let it be R rated....or else!!!!)

[PRPGfirerescuetech]

ummm, then why do i keep getting diverted?

This study is... :bs: