Pennsylvanians who are more frequently admitted to the hospital claim a disproportionate amount of public health money, according to a recent study by a state health cost-tracking agency. <\/p>\n
Research published in February by the Pennsylvania Health Care Cost Containment Council, or PHC4, shows patients admitted into a hospital five times or more between July 2013 and June 2014 comprised only 3 percent of total inpatient admissions. <\/p>\n
But those 3 percent ate up 14 percent or $545 million of all inpatient Medicare claims payments and 17 percent or $216 million of all inpatient Medicaid claims payments. <\/p>\n
It comes down to access. <\/p>\n
Patients who lack health insurance or a primary care physician, especially those with chronic illnesses like diabetes, heart disease or chronic obstructive pulmonary disease, often dont get regular care to effectively manage their symptoms. <\/p>\n
Richard Martin, M.D., department director for Geisigners community practices in Lackawanna and Monroe counties, said its a lack of regular maintenance that leads to catastrophe in the form of emergency room visits, followed by longer stays in the hospital. <\/p>\n
Many of these people just dont have insurance, he said. So they wait until an illness becomes more significant that they end up in the emergency department. <\/p>\n
Experts blame a flawed health care system, saying the burden, at least in part, falls on doctors to offer preventive and follow-up care patients need to stay out of the hospital bed and a few steps ahead of their illnesses. <\/p>\n
While it may seem these so-called super-utilizers are taking more than their fair share of public health resources, many health care professionals in the region are quick to caution against throwing accusations. <\/p>\n
I dont think it would be fair to say, well, these people are abusing the system; these people are feeding at the trough inappropriately, said Justin Matus, Ph.D., associate dean at Wilkes Universitys Sidhu School of Business. <\/p>\n
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Study: Health care 'super-utilizers,' cost ratio uneven<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Pennsylvanians who are more frequently admitted to the hospital claim a disproportionate amount of public health money, according to a recent study by a state health cost-tracking agency. Research published in February by the Pennsylvania Health Care Cost Containment Council, or PHC4, shows patients admitted into a hospital five times or more between July 2013 and June 2014 comprised only 3 percent of total inpatient admissions. But those 3 percent ate up 14 percent or $545 million of all inpatient Medicare claims payments and 17 percent or $216 million of all inpatient Medicaid claims payments. Continue reading