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In 2005, nearly half of the 1.5 million patients admitted to an Ohio hospital started in the ED. Add those patients who are treated and then released, and Ohioans made more than 5.2 million trips to their local ED, with the patients most often seen by ED staff being infants and one-year-old children. In fact, children up to 18 years of age made up nearly 30 percent of all ED cases where the patient did not require admission to the hospital. Hospital emergency room staffs treated ear, nose and throat concerns more than any other problem, and not because these patients were uninsured and without a general physician. Forty-seven percent of these children were covered by the Ohio Medicaid program and 41 percent had private insurance. Parents brought their children to a hospital ED not because they lacked insurance to visit a physician or an urgent care, but because the health problems peaked outside of normal office hours or were extreme enough to warrant immediate attention. Hospital emergency rooms serve as vital safety nets for members of their communities—not just for those with unexpected injuries, heart attacks or strokes, but for sick children who need immediate care at 2 a.m. Despite the increasing number of Ohio urgent care centers, the number of ED patients continues to grow. Medicaid covers 47 percent of the kids who visit EDs for treatment and don’t need to be admitted to the hospital and 45 percent of those kids whose conditions do require overnight stays. Medicaid helps hospitals cover the costs of this care, but it does not provide complete reimbursement. In 2005, hospitals lost $321 million in shortfalls from the Medicaid program, and emergency room care is a primary area where hospitals suffer financially because the services they provide are often costly and reimbursement remains low. The legislature is wrapping up discussions on the state budget, which currently includes an inpatient update for hospitals that would defray a portion of these losses. Adequate Medicaid reimbursement protects patients by helping ensure hospitals can continue providing this vital but expensive emergency care. Other legislation currently under debate in the Ohio Senate would require all hospitals to operate 24/7 emergency departments. Ohioans depend on hospitals for certain services such as emergency departments, and Senate Bill 120 would require that these services be available. Limited-service hospitals currently do not operate emergency departments, burn units or other less profitable services. This endangers citizens who may require immediate emergency care or those who mistakenly visit a limited-service facility seeking emergency care. It also puts the financial health and ED capacity of other local hospitals at risk as they are asked to treat more patients at the same time they may be losing more profitable services to specialty facilities. In addition to SB 120, OHA also is looking at other opportunities for improving the efficient use of hospital EDs. One example is hospitals’ support of Rep. Ross McGregor’s (R-Springfield) to proposed legislation that would support Federally Qualified Health Centers in Ohio, which could reduce ED visits by providing high-quality, affordable health care for populations who otherwise would not have access to primary and preventive care. Hospital emergency rooms prove invaluable each time a hurting patient walks through the doors – and those doors open more than five million times a year. All Ohio hospitals are dedicated to providing access to high quality care to their patients, and adequate funding and shared responsibility for emergency patients help ensure access to this care 24 hours a day, seven days a week.
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