NYC Study: Harlem Has Most ER ‘Super Users;’ Upper East Side, Fewest

Fred Mogul, Kaiser Health News, September 24, 2012

About 20 percent of New York City residents visit hospital emergency rooms annually—and in some neighborhoods, the rate is twice that, according to a new report.

The study by the United Hospital Fund found dramatic variations in ER use across the city, and it’s one of the first to analyze which people end up in the hospital the most.

Those least likely to wind up in the ER are residents of the Upper East Side and Astoria, Queens. About 9 percent make ER visits each year.

In Harlem, 40 percent of residents visit the ER—the highest rate in the city

The study, by Drs. Maria Raven and David Gould also focused on so-called “super-users,” who went to the ER more than five times annually, for three consecutive years.

Citywide, the study identified 4,147 super-users. These patients strain hospital resources, and many of their conditions could be treated better elsewhere.

For instance, asthma, which is considered relatively manageable with medication and modifications to behavior and environment, accounted for about 10 percent of the super-users’ visits.

And alcoholism and mental illness, relatively uncommon for the majority of ER visitors, occur relatively frequently among super-users—about 20 percent of the time.

{snip}

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  • Puggg

    Also, illegal aliens use ERs for general outpatient medical services.

  • humptydumpty

    While I’ve never been to a hospital in Harlem, I’ve known about this type of thing for many years. I used to live in Queens for many years and gave blood every three months at Elmhurst hospital and was shocked at how many people were always in the ER I had to go through to get to the blood donor room. The place was always filled to the gills. But I will say something else as well. Many minorities
    have a very short window of healthy living, seldom going into their third decade of life. Once their extreme youth passes them by, they’re generally very sickly people. 

    • I agree because they tend to suffer from diseases such as asthma and diabetes which if treated properly, will not lead to er vists at all. I would think that a number of these people are under Medicaid that would provide a primary care doctor, which Tenncare, which is what Medicaid is called in Tennessee, makes sure that all of the recipients have a primary care doctor to prevent overload at the emergency rooms. Illegal immigrants are responsible for much of the overcrowding at emergency rooms.

      • One of the arguments for the Affordable Care Act (ObamaCare) is that the reason people have treatable, chronic health issues and don’t visit the doctor for preventive care is because they can’t afford a doctor.
         
        ObamaCare is supposed to give these people affordable access to doctors which is supposed to lower health care costs.
         
        I work with a black woman who has asthma. She’s been to the hospital to be treated and once spent 5 days in the hospital.
         
        The kicker is, she smokes.
         
        She isn’t going to give up her bad habits. She wants to keep smoking and be treated for asthma.
         
        Most people with chronic health issues aren’t going to change. ObamaCare isn’t going to help any of these people because they won’t do anything to help themselves.

        And just two days ago, I was on the bus to work. I passed a very fat, old white man was riding his motorized wheel chair with oxygen tubes in his nose. He was also smoking.

    • KenelmDigby

      Yet, some people here insist that blacks are the ‘strongest’ people.

  • Defiant White

    Probably an incomplete story.

    10% of super-users suffer from asthma symptoms
    20% alcoholism and mental disease

    And since this is a colored ghetto . . .

    70% suffer from sucking chest wounds, multiple stabbings, blunt trauma, rape, ghetto-lobstering, overdoses and, no doubt, the occasional ninny who burned himself boiling up the water in which to cook the next YT he catches.

    • The__Bobster

      No, the boiling water is used on cheating lovers and to prepare ghetto lobster.

    • crystal evans

      Many of these people also suffer from diabetes. If it is not treated and the blood glucose level is not controlled. They are risking blindness and amputations due to gangerene.

  • Michelle Obama, specifically wife of a politician they vote for, was put in charge of “Community Relations” at UofC Hospital just so there would be a black person in upper management when they decided they needed to stop this practice and start shipping most of them to Cook County Hospital.

  • Ulick

    And then those Harlem ER users don’t pay their bills.  Rather than eating the loss, hospitals pass on the costs to the insured.  And since insurance companies don’t want to eat the cost, they raise their rates.  Ultimately, it’s you, me, and other reponsible Americans who pay for insurance that cover these trips to the ER.

    The same theory applies to shoplifting.  The lost profits from diproportionatley minority shoplifted goods are recouped in higher prices for you and me.  Lovely.

  • Long time asthma patient here.  Any human malady where the treatment requires long term consistent and timely participation and self-care on the part of the patient, blacks will have a lot of problems getting better.  Meanwhile, I had my last attack necessitating a trip to the ER at age 12.

    Incidentally, at that age, I got a new allergist.  It was then that I discovered that there was something not quite right about the medical profession.  He took me off the rescue inhaler I was taking and gave me another.  At first I thought different drug, different dosage, or something.  But when I got my first bottle of the new inhaler, I compared to to the label of my last bottle of the old inhaler, and they were exactly the same…EXCEPT for the company that made them.
    Then I realized that new doctor had all sorts of periphenelia indicative of that particular pharmaceutical around him.
    The next time I was scheduled to see him, I had to be re-scheduled for a “prior committment.”  Turns out that “prior committment” was a golf tournament in South Florida sponsored by that same pharma.  I was so happy for him that my mother’s co-payment for that inhaler helped pay for his greens fees.

  • Canada’s system is greatly helped by having the United States as a neighbor.

    A lot of these black ER patients have both legitimate emergencies and Medicaid or the New York equivalent, so I fail to see how your argument is valid in this case.  I’m sure there are good arguments for adopting some elements of that system, but this isn’t one of them.

    I am sympathetic to the argument of extending Medicaid to illegals because it will keep them out of the ER for sniffles.  But IF and only if we take it out of their home countries’ hides.

    • John Bonham

      Come on, that would be racist ..

  • Puggg

     
    As an aside, many blacks will not question the plan of care – they ask
    no questions regarding what it is they have or why they are ill or
    what/why they are taking. I get the impression that on some level they
    have concluded they won’t understand what I’m saying so why bother.

    Maybe they think they don’t have to pay attention because they think you’re giving them magical juju beans.  When they don’t work after one or two or three doses, if it’s the condition where just one or two or three doses aren’t enough, then they think you’ve given them bad juju beans, and that you wreak at voodoo.

  • toldev

     The problems in health care are parallel to the problems in education. The solution to both is exactly the same. Separate systems. Not that I see that happening in today’s political environment.

  • “Gimme dat, nome sayin”.

  • A few years back, a local TV station did a report on a black man who called an ambulance  for every trip to the hospital.

    By law, he couldn’t be denied access to an ambulance and he couldn’t be charged because he was poor.

    He used the ambulance for routine visits and chaulked up a tab in the tens of thousands dollars yearly. While it would have been far cheaper to give him a monthly bus pass, by law, he had the right to abuse the system.

  • newscomments70

    It’s refreshing to see such an eye-opening report from a dedicated professional. For me, this is proof that we can never live in the same space as the black community. All they will ever do is leach off of us while they attack us in the  most gruesome, violent ways you can think of. The horrors that they bring us are  beyond imagination. The racial tension continues to simmer, but eventually, the damn will break. At this point, we can no longer support and tolerate the black population. I stay alive so that I may one day see justice served. 

  • newscomments70

    If you need an ambulance, you will actually have to pay over a thousand dollars, even if you have insurance. Insurance used to pay for that…but since we have wonderful Obamacare, that coverage is gone. 

  • Dan Reardon

    Once you allow the government to completely take over health care you allow imbeciles like Sheila Jackson Lee, Maxine Watters and Barney Frank to make decisions on your well being. I’m not at all comfortable with that.

  • crystal evans

    I am wondering since many of these people have medicaid, do they not have access to a primary care doctor that would help them with these smaller issues such as colds, flu, etc. The doctor would be able to help them manage their diabetes or asthma. What would help ease the situation  would be a neighborhood clinic that would be staffed by Physicians Assistants or Nurse Practicioners that would be able to treat less serious claims such as colds, flu, etc and free the emergency room up for more severe cases.

  • 1.  You have to race norm life expectancies over countries.

    2.  I think the ideal health care paradigm will be a mix of private and public systems

    3.  I also don’t think it would be a bad idea to limit the pay packages and benefit packages and severance packages of CEOs of publicly traded corporations to a sensible multiple of the average or median of the entry level employees.  Either the Feds could do it using ICC, or the state that issues the charter of corporation (Delaware, in the case of most big American corporations) can make it a condition of incorporation.  But then you might run into a lawsuit over restraint of trade if Delaware tried something like that.  Probably Federally using ICC is the cleanest way to go.

  • 1.  A CEO of a publicly traded corporation is just as much an employee of the corporation as the entry level janitor, just higher on the totem pole.  The corporation ought not be his cornucopia any more than it can be the janitor’s cornucopia. Being a managerial munchkin is not the same thing as creating wealth.

    2.  I like Ross Perot’s idea for capital gains taxes:  Reverse stair-step them.  The longer you hold the asset, the lower the capital gains tax rate is.  This discourages quick buying and selling of capital gains and the societal havoc that it wreaks.  Imagine if we had this during the real estate bubble of the last decade.