O CDC (Center of Disease Control) liberou o relatório do atendimento ambulatorial nos Estados Unidos em 2005. Ele traz muita informação, mas reafirma uma tendência de aumento de utilização dos serviços de emergência pelos desprovidos de seguro-saúde. Há semelhanças importantes com o observado no Brasil, mas isso fica para outro momento.
Highlights of the report: There were over 1.2 billion patient visits to physician offices, hospital outpatient clinics, and emergency rooms in 2005. Over the past decade, rates of visits per population increased for all types of health care settings studied. In the emergency department, the visit rate for patients with no insurance was about twice that of those with private insurance. Conversely, patient visits to physician offices were higher for individuals with private health insurance compared with uninsured persons. Over 29 percent of all ambulatory care visits were for chronic diseases such as heart disease and diabetes, and one in four were for preventive care, including check-ups, prenatal care, and post-surgical care. There were 2.4 billion medications prescribed or administered at these visits.A agência Reuters apresenta comentários de Catharine Burt, uma das autoras do relatório.
"It was only a few years ago that we released that the total number of visits had reached 1 billion. And now we are up to 1.2 billion," "That's a 20 percent increase in the just the last five years -- a huge number," said Burt. "I can tell you that the number of hospitals and physicians has not increased 20 percent." The reason is clear -- Americans are getting older. "When you reach 50 things start going wrong, just little by little, and you keep going back to the doctors," Burt said. The baby boom generation -- born between 1946 and 1964 -- are now prime users of the medical system. Burt's team surveyed 352 hospitals and about 1,200 physicians throughout 2005 for the study. Of 2.4 billion drugs mentioned in patients' medical records in 2005, 118 million were antidepressants, Burt found. High blood pressure drugs followed, with 113 million and arthritis or headache drugs were mentioned in 110 million. "These are visits. These aren't people," she said. People taking antidepressants may need more frequent doctor visits. The report also shed light on the controversial issue of emergency room visits. Many health care experts are worried that the 43 million people who lack health insurance in the United States must rely on emergency rooms for care -- not the best way to prevent serious conditions. The survey suggests this is true. "People with no insurance are twice as likely to use the emergency department as the privately insured," Burt said. Nearly 28 percent of all doctors visits by uninsured people are to emergency rooms, compared to 6.6 percent of visits made by people with insurance. The report found that 46 million of the visits made to ERs in 2005 were by people with insurance, compared to 19 million by people without insurance. "With 315,000 people visiting emergency departments every day, the alarm bells are sounding and policymakers should heed the alert and respond," said Dr. Brian Keaton, president of the American College of Emergency Physicians, which is pressing for a national commission on access to emergency medical services.