ER wait times increase
Long waits in the nation's emergency rooms are nothing new. But research finds they're getting worse.
One in four emergency room patients in 2006 waited longer to be seen than recommended -- an increase of one in five from less than a decade earlier in 1997, according to a new study in the Archives of Internal Medicine.
With more people using emergency rooms for non-life threatening medical problems, the rates of ER usage have soared. In 1994, there were 93 million visits to the nation's ERs. In 2006 that figure spiked to 119 million visits, according to the study. And it's worst in urban areas. Three quarters of emergency departments in urban areas are at or above capacity, which means longer waits, people being diverted to other hospitals or people choosing to leave without getting care.
Overcrowding means not just unhappy patients, but can cause serious delays in treatment of conditions such as pneumonia, cardiac symptoms and abdominal pain, the authors write.
Researchers analyzed data from the National Hospital Ambulatory and Medical Care Survey to examine wait times. When a patient enters the ER, they are triaged -- processed and prioritized according to how severe their illness -- and given a recommended time by which a clinician should see them.
But no matter how patients were classified -- urgent patients were recommended to see a clinician within 14 minutes, while non urgent ones could be seen in up to 24 hours, for example -- patients in all categories saw their wait times increase.
The problem is not just with the ER, but it represents a "system-wide failure," says an accompanying editorial by Dr. Renee Y. Hsia and Dr. Jeffrey A. Tabas of the University of California, San Francisco. Hospitals need to reduce crowding, reduce stays and limit wait times, not only through the use of electronic medical records and quicker lab results, but with better access to care in other arenas, including more urgent care clinics and primary care offices, they write.
While health care reform offers some hope for improvement -- by expanding health insurance coverage to people who use the ER as their safety net --it's unrealistic to expect it to fix the problem, the authors write.
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