16 January 2008

Emergency room waits

A Harvard study shows that waiting times in U.S. emergency rooms, especially in urban areas, has doubled since 1997.
For patients ultimately diagnosed with heart attacks, the wait time rose from 8 minutes in 1997 to 20 minutes in 2004. Patients who needed attention within 15 minutes, according to triage nurses who evaluated them, waited 10 minutes in 1997 but 14 minutes in 2004.

In urban hospitals, the emergency room wait was 30 minutes compared with 15 minutes in nonurban locations.

For black patients, the wait took 31 minutes, for Hispanic patients it was 33 minutes, and for white patients it was 24 minutes. Women waited 26 minutes, one minute longer than men. The longer waits for black and Hispanic patients reflect greater crowding at hospitals serving mostly minority patients, the authors said. They did not find evidence of bias in how patients were triaged.

The longer wait times were tracked during a period when hospital emergency departments were being closed even though patient visits were going up, the authors say. Emergency visits climbed 78 percent from 1995 to 2003 but the number of emergency departments fell 12.4 percent from 1995 to 2003.

Fewer emergency departments could be one explanation for the longer wait times, but Wilper also pointed to a lack of beds for seriously ill patients once they are admitted to the hospital. This Globe story explored efforts in Massachusetts to reduce “boarding,” when admitted patients stay in the emergency department, sometimes for 10 or more hours until a regular hospital bed becomes available.

Other drivers of lengthening wait times could be a shortage of specialists on call to see patients in the emergency department and a lack of access to primary care for people who go to the emergency room for non-urgent needs.
It's difficult for most of us to get a handle on this -- hospitals moving to the suburbs, a lack of primary care for and increasing number of people, fewer physicians willing to do hospital work -- and how it all ties in to our asinine system of financing health care.

Mostly it's easier to set sights on those uninsured people, coming to the hospital for non-urgent needs. That needs to be stopped, eh? They should wait until their needs are urgent.

Like Paul did.

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