What’s a typical emergency room visit cost? That depends, not only on the service or procedure, but the hospital, according to a new study that found dramatic variations in costs for ER outpatient treatments across the country.
The study, led by researchers from the University of California-San Francisco, found huge price swings in patient charges for the 10 most common outpatient conditions in emergency rooms. Out-of-pocket patient charges ranged from $4 to $24,110 for sprains and strains; from $15 to $17,797 for headache treatment; from $128 to $39,408 for kidney stone treatment; from $29 to $29,551 for intestinal infections; and from $50 to $73,002 for urinary tract infections.
The study, published online in the Public Library of Science journal in PLOS ONE, is based on medical expenditure records from the Agency for Healthcare Research and Quality representing an estimated 76 million emergency department visits between 2006 and 2008. It is the first to demonstrate a large, nationwide variability in charges for common emergency department outpatient conditions, according to the researchers.
“Our study shows unpredictable and wide differences in healthcare costs for patients,’’ said researcher Renee Y. Hsia, M.D., an assistant professor emergency medicine at UCSF and an attending physician in the emergency department at San Francisco General Hospital & Trauma Center.
“Patients actually have very little knowledge about the costs of their health care, including emergency visits that may or may not be partially covered by insurance. Much of this information is far too difficult to obtain.’’
Rising healthcare costs, cost controls, and transparency in the nation’s emergency rooms are increasingly important, the authors said, particularly for medical conditions that are less time-sensitive. When it comes to emergency rooms, visited by an estimated one in five Americans annually, patients as well as their physicians are often in the dark about billable charges, Hsia and colleagues said.
The study focused on the total ER charges — for medical care, tests, and treatment — of more than 8,300 adults, 18 to 64 years old, half of whom were privately insured. Among key findings:
- The median charge for total outpatient conditions was $1,233.
- Upper respiratory infections had the lowest median charge: $740.
- A kidney stone condition had the highest median price: $3,437.
- Uninsured patients were charged the lowest median price ($1,178) followed by those with private insurance ($1,245) and Medicaid ($1,305).
“While most patients with time-sensitive conditions such as [heart attack], stroke, or sepsis may not be in a position to make decisions about their care based on costs or charges, there are many situations in which patients could reasonably inquire about the potential financial implications of their medical care before making treatment decisions,’’ the authors said.
They added that more transparency in hospital charges is needed, and consumers should be better informed about the costs of their medical care.
The study was funded, in part, by he Robert Wood Johnson Foundation and the National Institutes of Health.
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