K John McConnell1, Craig D Newgard, Raymond Lee. 1. Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR 97239, USA. mcconnjo@ohsu.edu
Abstract
STUDY OBJECTIVE: We measure changes in the prevalence and magnitude of stipends and other payments for taking emergency call during a 2-year period for hospitals in Oregon and evaluate the ways in which hospitals are limiting services and assessing policy options. METHODS: This was a longitudinal, standardized, e-mail-based survey of chief executive officers from all hospitals with emergency departments (EDs) in Oregon (N=56). The first wave was conducted in the summer of 2005; a follow-up survey was conducted in summer 2006. Hospitals reported on-call payments made to 8 selected specialties. RESULTS: Among 56 Oregon hospitals with EDs, 43 responded to our survey in both 2005 and 2006, representing a 77% response rate. Among 54 specialties receiving stipends in 2006, the average stipend was $18,324. Total annual stipend payments increased by 84%, from an average of $227,000 per hospital in 2005 to $487,000 per hospital in 2006. In Oregon, between 2004 and 2006, 67% of hospitals lost the ability to provide coverage for at least 1 specialty on a 24-hour, 7-day-a-week basis. Approximately half of hospitals (49%) manage this lack of coverage by transferring patients to other hospitals on a case-by-case, ad hoc basis. CONCLUSION: The cost of maintaining on-call coverage is increasing in Oregon, raising concerns about hospital financing and a degradation of the emergency services. There has not been a systematic response to on-call shortages, with patient transfers primarily managed in an ad hoc, case-by-case basis.
STUDY OBJECTIVE: We measure changes in the prevalence and magnitude of stipends and other payments for taking emergency call during a 2-year period for hospitals in Oregon and evaluate the ways in which hospitals are limiting services and assessing policy options. METHODS: This was a longitudinal, standardized, e-mail-based survey of chief executive officers from all hospitals with emergency departments (EDs) in Oregon (N=56). The first wave was conducted in the summer of 2005; a follow-up survey was conducted in summer 2006. Hospitals reported on-call payments made to 8 selected specialties. RESULTS: Among 56 Oregon hospitals with EDs, 43 responded to our survey in both 2005 and 2006, representing a 77% response rate. Among 54 specialties receiving stipends in 2006, the average stipend was $18,324. Total annual stipend payments increased by 84%, from an average of $227,000 per hospital in 2005 to $487,000 per hospital in 2006. In Oregon, between 2004 and 2006, 67% of hospitals lost the ability to provide coverage for at least 1 specialty on a 24-hour, 7-day-a-week basis. Approximately half of hospitals (49%) manage this lack of coverage by transferring patients to other hospitals on a case-by-case, ad hoc basis. CONCLUSION: The cost of maintaining on-call coverage is increasing in Oregon, raising concerns about hospital financing and a degradation of the emergency services. There has not been a systematic response to on-call shortages, with patient transfers primarily managed in an ad hoc, case-by-case basis.
Authors: Craig D Newgard; Dana Zive; James F Holmes; Eileen M Bulger; Kristan Staudenmayer; Michael Liao; Thomas Rea; Renee Y Hsia; N Ewen Wang; Ross Fleischman; Jonathan Jui; N Clay Mann; Jason S Haukoos; Karl A Sporer; K Dean Gubler; Jerris R Hedges Journal: J Am Coll Surg Date: 2011-12 Impact factor: 6.113
Authors: Sophie Terp; Seth A Seabury; Sanjay Arora; Andrew Eads; Chun Nok Lam; Michael Menchine Journal: Ann Emerg Med Date: 2016-08-02 Impact factor: 5.721
Authors: Heena P Santry; Scott A Strassels; Angela M Ingraham; Wendelyn M Oslock; Kevin B Ricci; Anghela Z Paredes; Victor K Heh; Holly E Baselice; Amy P Rushing; Adrian Diaz; Vijaya T Daniel; M Didem Ayturk; Catarina I Kiefe Journal: BMC Med Res Methodol Date: 2020-10-02 Impact factor: 4.615