If you have a medical crisis, it is good to know that a hospital emergency room is only an ambulance ride away. ________________________________________ Earlier today I spoke with to me choose Alexia compress the and CEO of the hospital association of San Diego. ________________________________________ Over the past decade emergency room visits have increased by 40%. While the population has gone up by 7%. Demetrius was going gone? ________________________________________ What we have seen in most recent times, is the growth. What was a problem. If you look back, our most successful public advocacy program was called 911 when you have an emergence the. And with the expansion through the affordable care act, and the growth that we have seen through medic Cal expansion. There are a lot more people will have coverage previously did not. ________________________________________ Ultimately, with that comes education that needs to be done in terms of where they should be accessing care at the appropriate settings. ________________________________________ Why are people going to the emergency room for things that can be handled more easily, and more efficiently in other settings? ________________________________________ You have to look at where the majority of the growth in most recent times has happened, primarily been in Medi-Cal. In San Diego County for example, packing 2012, you had about 300 312. Now as we say here there is over 800,000 people. More than doubling it. You may be aware that California is a poor payer in terms of reimbursement coming in terms of Medi-Cal and creates challenges. Finding access to primary care physicians and clinics which do play a large role in our delivery system. They are already impacted and have been pretty crowded. And continue to try to expand and meet up with demand. In terms of hospital emergency departments, it requires that every hospital be open 24/7 and they continuously receive patients. Two the emergency department becomes easy access. ________________________________________ Now you are quoted as saying the local emergency service system is that it to pinpoint what do you mean by that? ________________________________________ For example, we have had one hospital ED treating 40,000 people now upwards of two 100,000 people. You do get to a capacity challenge. Hospitals over the years have expanded their emergency departments. You can go to every system and they have done their part to continue to expand. The bonds continue to go up, you do get to a point where there is a challenge keeping up with the demand. Particularly, when you are treating things that could have gone to an urgent care setting. And that gets problematic as ultimately, hospitals have and will continue to serve the public when it comes to true emergencies. But we want to ensure that people are getting to the right setting. That is where the challenge comes into play. You have all you issues that come into and factoring. ________________________________________ How can these volume issues of fact how San Diego hospitals can deal with a true regional health crisis? Like an earthquake or in epidemic? ________________________________________ We to have capacity plans in terms of how to deal with those types of innings. Mitigation factors that we act be as we get to certain levels. There is no reason for the public to be concerns, in terms of overall capacity. That is something hospitals caught EMS offers responders always are there. And we are looking to continue to work together when you have those types of challenges. Two with the current ED volumes, that would pose a potential challenge if you had a very busy day. And then you had a natural disaster. But, like anything else, but figure that out as well. ________________________________________ What are some of the things that San Diego skin to to avoid going to emergency rooms for nonemergencies? ________________________________________ Is a matter of knowing. Coverage, having a primary care physician, a medical home. Those all important first steps. If you understand where you should be accessing care, for example, if you have a young child and later in the evening, and they have an elevated temperature, it's having access to a phone number to call, rather than going into an emergency department. ________________________________________ If it is an emergency, continue to use it. But for items that can be treated at home, or seen in a physician's office, that would be a recommended choice to help with crowding issues. ________________________________________ Demetrius, I understand the hospital emergency palmistry people in terms of acuity. If you come in with a Steptoe are cut finger, they will have you wait. If someone comes in with a bullet will -- won't? ________________________________________ Is that right? ________________________________________ Yes. They have triage upfront urgent care and other settings that they can recommend. You are correct in that if you come in with a step Truax, and a trauma comes in, and there is only one bed available, the trauma will get access to that bed prior to the stepped toe. ________________________________________ The me ask you lastly, is this a problem that affects hospitals in San Diego County or is it nationwide? ________________________________________ Is a nationwide issue throughout the state. You will see this issue throughout our state but it's not like it just came up yesterday as it has been going on for some years. Especially with expanded access our coverage. Which increases axis challenges. But what that there have been efforts. Through the California Hospital Association, state EMS Authority, we have had conversations put together a toolkit, to illustrate that this is a larger issue and then we need to work collaboratively. ________________________________________ And you can see in other countries as well. It's not unique even to the United States. ________________________________________ Thank you very much. I have been speaking with Demetrius Alexia Pres. and CEO of San Diego and Imperial Counties.
Over the last decade, more than half of the visits to San Diego emergency departments have been for non-emergencies.
That's the word from local health officials, who recommend that San Diegans go to an emergency room only if they're suffering an urgent crisis.
Officials say emergency department overuse can lead to overcrowding and longer wait times.
“Our most successful public advocacy campaign in a larger sense was call 911 when you have an emergency,” Dimitrious Alexiou, president of the Hospital Association of San Diego & Imperial Counties, said Monday on KPBS Midday Edition.
Alexiou said coverage expansion through the Affordable Care Act and Medi-Cal may be behind the problem.
“There's a lot more people who now have coverage who previously didn't,” Alexiou said. “And ultimately with that comes some education that needs to be done in terms of where they should be accessing care at the appropriate settings.”
