ER "super users" and New Jersey

Repeat ‘super users’ are swamping the ER

by Carol Ann Campbell/The Star-Ledger Sunday July 13, 2008, 8:45 AM

Bean-thin and sallow, George tugged on a cigarette in the blistering parking lot of a Camden men’s shelter. Standing on the pavement, his foot on a picnic bench, he recalled how he took his first drink at 13.

George, here talking to a social worker in Camden, is an emergency room ”super user,” having been admitted to ERs in the small city between 30 and 40 times in the past year.

The hard living shows in the lines of George’s face — and in his medical history. When he gets sick, which is often, the 55-year-old has no place to go except one of the city’s emergency rooms.

George is a “super user,” a new name coined to describe people who turn to the ER with astonishing frequency and at an astonishing cost to a health system under siege on all fronts.

This is a very well written article, and I’d bet every ED in America has the same group of ‘super users’, patients who are in the ED a lot, not because they want to be but because for a variety of reasons they don’t have other choices.  It’s unfortunate that their only choice is horribly expensive and fragmentary care.

Nobody has an answer to the problem, but I applaud New Jersey for trying to do something about it.