Cutting Back On "Frequent Flyers"

| Good news, Levitt: your dream of emergency-only E.R.’s may be more realistic than you think. A program in Camden, N.J., hospitals to cut down on repeat visitors (known to E.R. docs as “frequent flyers”) seems to be working. (HT: Megan Williams) [%comments]


My father-in-law works with a team of doctors who make weekly home calls on similar patients. I think he enjoys the work, and it's clearly a huge savings for the insurance company (usually Medicaid) covering their care.

Johnny E

Has anybody ever analyzed the freakonomic impact of the Reagan years when they emptied out asylums and cut back on low-cost housing drastically enlarging the homeless population? You never used to see that many indigent people on the streets except in small skid-row districts.

Perhaps one way to solve the emergency room problem would be for medical practices to hire retired doctors on a part-time basis to make house calls. Now that all their retirement investments went sour they could probably use some spare cash. If they lived in a retirement community their services are probably in demand.


This article implies but does not state the obvious solution: Solve the problem of tens of millions of Americans having no health insurance, and you'll drastically reduce, if not completely solve, the overcrowded ER problem.


@Jeff - You are implying that overcrowded ER's are the direct result of lack of universal insurance. While there is certainly a subset of patients that do not have insurance at all, the main reasons I have seen for ER visits are:
(1) Lazy or litigation-scared primary doctors who tell a large number of unscheduled patients to go the the ER
(2) The lack of access to 'convenient' primary care (as defined from the patient's perspective).
(3) The refusal or lack of knowledge as to the most cost-effective and appropriate way to receive care.

'Free' healthcare does not solve any of these issues - many people today are guided into the most cost-effective care by their deductibles and co-pays, and from a litigation perspective, ER's can't kick people out untreated for non-emergent issues - which will discourage improper resource usage.

The point of the linked article is valid, but the data in it is no surprise and is yet another repeat of previously done studies. One answer is to have EMS (The EMTs and Paramedics) perform some in-home checkups during their down times. The problem is that Medicare, and the other insurance companies, will not pay for these types of visits, even though the efficacy and cost savings has been proven for years.