Hospital Emergency Department for Children’s Primary Care?

November 26, 2008

Everyone expected the ER patient load to go up as the number of people with affordable (or any) insurance goes down, but the fact that some people with insurance actually prefer the ER for routine pediatric care over their PCPs isn’t exactly common knowledge.

There’s a new piece in the Washington Post about the “non-urgent” patient load handled in pediatric emergency rooms that’s a must-read. Everyone expected the ER patient load to go up as the number of people with affordable (or any) insurance goes down, but the fact that some people with insurance actually prefer the ER for routine pediatric care over their PCPs isn’t exactly common knowledge.

The article is based off of a study in Ambulatory Pediatrics, which found that not only were parents choosing to skip the PCP visit altogether, but some PCPs were actually referring them to the ER. The analysis was based off of data collected from 31 families who visited the pediatric emergency department for non-urgent care between the hours of 8:00AM and 4:00PM on weekdays over a period of four weeks.

The fact that data was collected at only one hospital is a limiting factor, so it would be interesting to see additional research that included multiple facilities around the country. Studies like this can be helpful — when they are not viewed by the professional community as “finger-pointing”- at a time when the country is considering a healthcare system overhaul. I don’t think pediatricians are at fault, but I take exception to responses from professionals (such as the one interviewed for the Post article) who try to boil the matter down as convenience for parents. “Convenience” is becoming a necessity, not a choice — and the current economy only increases this fact. Most parents work and simply cannot afford long waits or referrals.

Our current healthcare system encourages referrals in primary care. The ER, on the other hand, is one-stop shopping. What are your thoughts?

On the technology side, Siemens has announced that it will introduce a new CT scanner, the Somatom, to the market in the first quarter of 2009 at a lower dose of radiation. This could make things easier on kids - they wouldn’t have to hold their breath, and they’d be in and out quickly.

A German company, MBR Optical Systems, has also recently announced a product called Haemospect, which is a hand held, non-invasive blood and tissue analyzer. You can read the press release here and see the product description here. The device was presented last week at Medica 2008 in Düsseldorf, but I don’t see a device approval in the FDA database at this point. However, it may be on its way.

That’s the news for this week. Have a happy and safe Thanksgiving, everyone!