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'Super-Users' Provide Big Challenges for City ERs: Study

Sunday, September 16, 2012

Around 20 percent of New York City residents visit hospital emergency rooms annually, according to a new report — and in some neighborhoods it's twice that.

The study by the United Hospital Fund found dramatic variations in ER use across the city, and it's one of the first to analyze which people locally end up in the hospital the most.

Those least likely to wind up in the ER are residents of the Upper East Side and Astoria, Queens. About 9 percent make ER visits each year.

In Harlem, 40 percent of residents visit the ER — the highest in the city

The study, by Drs. Maria Raven and David Gould also focused on so-called “super-users,” who went to the ER more than five times annually, for three consecutive years.

Citywide, there are about 4,100, but they strain hospital resources, and many of their conditions could be treated better elsewhere.

For instance, asthma, which is considered relatively manageable with medication and modifications to behavior and environment, accounted for about 10 percent of the visits among super-users.

And alcoholism and mental illness, relatively uncommon for the majority of ER visitors, occur relatively frequently among super-users — about 20 percent of the time.

The study authors say the figures underscore the need to further develop what are called “medical homes” — centers within hospitals and clinics that intensively focus on all aspects of high-needs patients’ lives.

Starting this fall, under the Affordable Care Act, the federal government will penalize hospitals that don’t do enough to prevent people from coming back repeatedly.

The data for the study comes from a combination of city and health departments and individual hospitals from 2006 to 2008.

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Comments [1]

John Stockton from Nottingham. U.K.

You need a National Health Service paid for through taxation. It works. The health service in Britain is under strain not because of any intrinsic problems of the system but because it has been systematically sabotaged by successive governments. Most the problems in the British health service result from ‘reforms’ designed to introduce privatisation and make it more American. A properly funded health service allows patients with chronic health issues to be treaded as out-patients before their conditions deteriorate to the point where they warrant emergency treatment. Many poor people have worked hard all their lives. Just because they have failed to accumulate wealth it should not follow that they do not deserve to be treated as human beings. Anyone who thinks that this is socialism is probably right. It’s what most people need.

Sep. 16 2012 02:59 PM

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