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    Too Many Heart Attack Victims Don't Call 911


    "Time is muscle," Meyerson says. "The longer you wait, the more heart muscle dies."

    Although the survey didn't ask people directly whether cost was a factor in their decision to call 911, it was noted that in areas that had either state-supported emergency medical services or a subscription service, the service was used twice as often as in areas that didn't have it.

    "Cost could be a part of it," says David E. Wilcox, MD, FACEP, a spokesman for the American Academy of Emergency Medicine Physicians. He points out that some managed care programs have denied coverage if it was later learned that the person didn't have a serious problem.

    To combat this, now at least 32 states have passed legislation to define "emergency" based on a layperson's interpretation, and a federal bill seeks to do the same. "If you have signs or symptoms that you interpret to be a potential emergency, and you go to the ED to have it checked out, the insurance company must pay for it," says Wilcox in an interview with WebMD. Wilcox also is medical director of ConnectiCare and a practicing emergency room physician at St. Francis Hospital in Hartford.

    It's important to get the "prudent layperson" definition of emergency through the federal legislature, says Wilcox, because under the Employee Retirement and Income Security Act (ERISA), large companies that are self-funded do not fall under state law. So even though 32 states have passed the statute, big companies that account for about 40% of all employees in the country don't fall under it, he says.

    "If you have a service that is free to you, [cost] is not a roadblock to using it," says Wilcox.

    For more from WebMD, read how to recognize an emergency.

    Vital Information:

    • In a recent study, researchers found that less than a quarter of emergency room patients with chest pain, a symptom of heart attack, used emergency medical transportation, with some even driving themselves to the hospital.
    • Among people who first called their doctors, emergency medical service use was lower, which worries researchers who think these people may be lulled into a false sense of security.
    • The benefits of using emergency medical services is that treatment begins upon arrival and the emergency department can be notified in advance, so care on arrival to the hospital can be quicker.
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