County to limit access to ERs

From the Houston Chronicle:

Harris County's public hospitals are about to tighten access to their emergency rooms, which for decades have served as the doctor's office for some patients with noncritical medical needs.

On Tuesday, what has been an open-door policy at Ben Taub and LBJ hospitals will become stricter.

To reduce emergency room overcrowding, the hospitals for the county's needy will begin screening adult patients and requiring those who don't need urgent care to seek treatment in community health clinics.

"We've been enabling primary care treatment in emergency rooms, but not liking it," said Bryan McLeod, spokesman for the Harris County Hospital District. "So what do we do to change things? This is one of those options."

Patients who go to the county's emergency rooms with nonurgent symptoms sometimes wait 12 hours or more for treatment.

Waits also are long and scheduling difficult at clinics. But there will be an incentive for seeking treatment in the appropriate setting: money.

After evaluating patients who come to the emergency room, nurse practitioners or physician's assistants will inform those with nonurgent symptoms that they can seek treatment at a specific community health clinic.

Patients who insist on staying will have to pay a $150 deposit before being treated in the emergency room or an $80 deposit to be seen in urgent care centers at LBJ and Ben Taub.

These are comparable to private minor emergency centers that treat non-life-threatening trauma and illness.

The district is beefing up the urgent care staff at LBJ and expanding the urgent care center's hours to help treat patients diverted from the emergency room. Construction will begin soon on a $650,000 urgent care center near Ben Taub's emergency room.

Except for the new deposit requirement, the cost for treatment at district facilities will be on a sliding scale, based on patients' financial situation, as it is now. Children 17 and younger won't be subject to the diversion program, though the district will encourage parents to take children with nonurgent symptoms to clinics.