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Thursday, February 21 , 2019, 1:12 am | Fair 47º


Emergency Rooms Still Seeing High Patient Volumes in Santa Barbara County

Hospitals are hoping that visits will decrease as more patients get insurance and use primary-care doctors

A key goal of health-care reform was to get people out of the emergency room and into the offices of primary-care doctors, but Santa Barbara County emergency rooms are still seeing large numbers of patients.

Using the ER as an all-stop-shop for care is an expensive, inefficient way to provide health care, so the new policies emphasize a patient-centered medical home, which focuses on preventive care and linking a primary-care doctor to each patient as a sort of health case manager.  

Emergency room usage in Santa Barbara County has increased over the last year, even though more people have insurance coverage, CenCal Health CEO Bob Freeman said.

“It’s gone as you would expect — even though they’re signed up, it still takes time to sink in that they actually have a doctor and they can utilize it,” he said.

CenCal manages the Medi-Cal program for San Luis Obispo and Santa Barbara counties.

“Also, many of these people who hadn’t had insurance before, the access to care would be through the ER … we’re theorizing that old habits die hard,” Freeman said.

Santa Barbara County’s Medi-Cal enrollment grew 37 percent overall since October 2013, with the highest concentration in the South County, according to the county Department of Social Services.

That represents an increase of 29,400 people in the publicly funded program.

The speed and volume of the Medi-Cal enrollment growth exceeded all projections, Freeman said.

Meanwhile, the Tri-County area of San Luis Obispo, Santa Barbara and Ventura counties had 61,784 individuals sign up for the state-run health insurance exchange, Covered California, and 89 percent of them received a subsidy of some kind, according to data gathered by the state.

Overall demand for medical care has increased over the last year, which is a good thing, Freeman notes.

Without insurance, many people would go to the most expensive venue, the ER, and only after their condition got serious from being unattended for so long, he said.

“Now, we hope to see that finally evolving,” he said.

As Noozhawk reported in its Safety Net series last year, local emergency departments already were swamped with patients.

There are five emergency rooms in the county: the Cottage Health System’s hospitals in Goleta, Santa Barbara and Santa Ynez; Lompoc Valley Medical Center; and Marian Regional Medical Center in Santa Maria.

The Santa Barbara Cottage Hospital ER was designed to handle 25,000 visits a year but doctors had 43,800 visits in 2012.

There are construction plans to double the size by 2018, and the hospital works with community organizations to track and deter “inappropriate” ER visits, particularly frequent visits by local homeless residents.

Santa Barbara Cottage Hospital’s emergency room visits are about the same this year compared to last year, spokeswoman Maria Zate said.

Cottage is seeing many people in the ER with Covered California insurance this year, but it’s impossible to use that as a comparison since the program didn’t exist before 2014.  

Emergency department visits from January through September in 2013 totaled 34,134, and in the same period this year, the ER had 34,001 visits, a very slight decrease.

“We do expect that the emergency department visits will decrease in the future as more people with insurance will have access to physicians when they have health issues and will not have to use the ED except for cases of true emergency care,” Zate said.

Marian Regional Medical Center had its emergency room visits double over the past 15 years, to almost 53,000 in 2011.

With the new hospital built in 2012, the emergency department expanded.   

“There has been a steady increase in ER visits with the opening of the new emergency room two years ago,” Dignity Health spokeswoman Samantha Scroggin said.

Since January, the emergency room visits at Marian have increased to an average of 204 per day, up from 186, she said.

It’s hard to pin down a trend since emergency room volumes fluctuate, and November is showing an average of 194 visits per day, Scroggin added.

Noozhawk news editor Giana Magnoli can be reached at .(JavaScript must be enabled to view this email address). Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.

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