Tuesday, March 11, 2008

Hospital Rejections of Emergency Patients Endemic

Update 1 [March12, 2008]: The Japan Times spent a little extra time crunching the survey numbers it seems. Apparently there were more than 24,000 instances where a patient seeking emergency medical care was denied admission by at least three hospitals. Of this number, a little more than 14,000 were classified as "seriously ill". 8,618 cases involved individuals aged 14 or younger, and 1,084 involved pregnant women.

Original Post:
I commented on this last year (click here), but now there's more information coming out about the practice of hospitals rejecting patients in Japan.

A recent survey revealed that more than 14,000 patients requiring emergency medical attention in 2007 were rejected by at least three hospitals, and a little over 1,000 were denied by at least 10.

I actually saw a late-night news program/documentary about this same topic on TV last week. They interviewed some health professionals who mentioned that they had been coached on the best ways to reject patients. They showed several clips of ambulance dispatchers calling hospital after hospital and the voice on the other line giving one excuse or another for why they couldn't accept the patient.

Several times it sounded like the person on the other end of the line just couldn't be bothered to deal with any extra excitement at that hour of the night. To be fair, however, I saw footage of an ER on the news this evening, and they were clearly understaffed. Obviously, some of the rejections are warranted.

In the article, it was reported that one woman was rejected by 49 hospitals before finally being admitted (her fate was not noted). The survey did not keep track of how many people died as a result of the hospital rejections, but such cases have been publicized recently.

In December, an 89-year-old woman died after an ambulance crew spent two hours trying 30 hospitals before finding one that would accept her for treatment.

The news program that I saw on TV mentioned that while being an ER doctor in the United States is a position that commands a decent amount of respect and pay, the same can not be said for the situation in Japan. Naturally, not that many med students plan to become ER doctors.

I would love to see comparable numbers for hospital rejections (patients being denied admission), specifically with regard to patients requiring emergency treatment, in the United States. I'm sure that it happens--I just want to know how often. And how often is insurance a factor in whether or not a patient is admitted to a hospital?

Anyone have any info on this?


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