No reduction in ER burden seen after hike in specialists' fees
A rise in Emergency Room (ER) specialists' fees at the start of this month has not led to a reduction in wait times, "Aktuaalne kaamera" reported.
Last year's hike to the specialist visit fee to €20 was justified partly to reduce the burden on ER departments. The fourfold increase took effect this month; the previous €5 fee had been in place since 2013.
Arkadi Popov, head of West Tallinn Central Hospital (LTKH), said: "We have compiled statistics from April 1-20. We specifically counted how many walk-ins there were compared with the previous year, and it turned out that the numbers are practically identical."
North Estonia Medical Centre (PERH) ER chief Marit Märk agreed, noting the hiked fee changed the demographic of those coming to ER even if it hadn't reduced the numbers.
"I have noticed that the pensioner who comes with a chronic issue – there are fewer such patients now – but there is the vigorous young person who thinks that for €20 they can come to ER, quickly get service and then go and continue their workday from where they left off," Märk said.
Another change at PERH starts May 1, when nurses, rather than doctors, will handle lower priority patients, Märk added. "This is the model we are using to try to control somewhat the number of walk-ins, and to free up medical resources for the ambulance zone to deal with more severe patients."
A change in patients' attitudes has also been observed at Tartu University Hospital.
Ilona Pastarus, head of patient experience at Tartu University Hospital, said: "For this €20 visit fee, perhaps a bit more is now expected from ER, meaning people want faster service and maybe expect some package of examinations and tests, given the fee."
According to Popov, ER is busiest during weekday daytime hours, when family doctors are also working. Hospitals themselves cannot ease the overcrowding, he noted, adding the issue should be addressed nationally. For example, in Finland, emergency care can be obtained from centers that are not as well-equipped as hospitals. In such cases, basic service levels may limit tests, and access to higher-level ERs would require a referral, Popov noted.
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Editor: Valner Väino, Andrew Whyte
