The On-Call Crisis: A Statewide Assessment of the Costs of Providing On-Call Specialist Coverage

Kenneth (John) McConnell, Loren A. Johnson, Nadia Arab, Christopher F. Richards, Craig Newgard, Tina Edlund

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Study objective: A recent change in the delivery of emergency care is a growing reluctance of specialists to take call. The objective of this study is to survey Oregon hospitals about the prevalence and magnitude of stipends for taking emergency call and to assess the ways in which hospitals are limiting services. Methods: This was a cross-sectional, standardized survey of chief executive officers from all hospitals with emergency departments in Oregon (N=56). This e-mail-based survey asked about payments made to specialists to take call and examined changes in hospitals' trauma designation and ability to provide continuous coverage for certain specialties. Results: We received responses from 54 of 56 hospitals, representing a 96% response rate (100% of trauma centers). Twenty-three of 54 (43%) Oregon hospitals pay a stipend to at least 1 specialty, and 17 (31%) hospitals guarantee pay for uninsured patients treated on call. Stipends ranged from $300 per month to more than $3,000 per night, with a median stipend of $1,000 per night to take call. Trauma surgeons, neurosurgeons, and orthopedists were the specialists most likely to receive stipends. Seven of 54 (13%) hospitals have had their trauma designation affected by on-call issues. Twenty-six hospitals (48%) have lost the ability to provide continuous coverage for at least 1 specialty. Conclusion: Problems with on-call coverage are prevalent in Oregon and affect hospital financing and delivery of services. A continuation of the current situation could degrade the effectiveness of the trauma system and adversely affect the quality of emergency care.

Original languageEnglish (US)
JournalAnnals of Emergency Medicine
Volume49
Issue number6
DOIs
StatePublished - Jun 2007

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Costs and Cost Analysis
Wounds and Injuries
Emergency Medical Services
Hospital Chief Executive Officers
Quality of Health Care
Trauma Centers
Postal Service
Hospital Emergency Service
Emergencies
Cross-Sectional Studies

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

The On-Call Crisis : A Statewide Assessment of the Costs of Providing On-Call Specialist Coverage. / McConnell, Kenneth (John); Johnson, Loren A.; Arab, Nadia; Richards, Christopher F.; Newgard, Craig; Edlund, Tina.

In: Annals of Emergency Medicine, Vol. 49, No. 6, 06.2007.

Research output: Contribution to journalArticle

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