Payor Type COMMERCIAL MEDICAID MEDICARE OTHER SELF PAY WORK COMP Total
Number of Patients
% 3146 25.44% 3687 28.56% 3381 26.19% 139 1.08% 2418 18.73% 0 0.00% 12909 100.00%
The majority of ED visits were higher acuity level visits- levels 3 or 4 (34.8% and 28.6% respectively); 17.7% was level 2; and 17.0% was level 5. Less than 2.0% of visits were for low level (0-1), non-acute visits. In the Community Health Survey, 16.6% of respondents said they use the Emergency Department (ED) for medical, dental and mental health or substance abuse problems with 18.2% of the households not having any type of health insurance. The majority of respondents, 74.5% had been to the ED in the past two years. The top reasons for visits were illness; accident; and mental health issues. Emergency Medical Services There are three Emergency Medical Service (EMS) agencies in Giles County including Carilion Patient Transport Services, Giles Lifesaving and Rescue Squad, and Newport Volunteer Rescue Squad. The EMS agencies are volunteer-staffed with the exception of Carilion Patient Transport Services. All are certified by the Office of Emergency Medical Services and provide advanced life saving support, search and rescue services. The Carilion Patient Transport Services reported 1,105 calls in the first four months of 2012 with 83% of the calls for adults and 17% for children.39 Although a majority of the calls were for acute conditions, often calls regard non-acute primary care needs. The Captain of the Giles EMS and Carilion Clinic Patient Transportation reported that the population served by the organizations has a hard time in obtaining primary care and medication used to manage long term illnesses. This is illustrated time and time again in patients that do not seem to have access to medications for management of their hypertension, Congestive Heart Failure (CHF), and mental illness diagnosis. Emergency responders serve many patients repeatedly for the same symptoms, as a result of the patients not having access to someone to help them manage their disease process long term. It seems the cycle repeats in that they call 911, EMS treats them en route to the hospital, the hospital provides medication for short term management and they are discharged for the cycle to
39
Carilion Clinic Patient Transportation LLC, QM Statistical Report by Month, January-April, 2012
45