Unemployed, Uninsured Patients Could Overwhelm US Hospitals

Ruzanna Harutyunyan's picture

Emergency departments, many "already overburdened," could face more difficulty handling increased caseloads because of the rising number of unemployed and uninsured people using EDs for basic medical care, the New York Times reports. According to the Times, many EDs already were overcrowded before the recession, which has lead to increasing job and insurance coverage loss. A report released Tuesday by the American College of Emergency Physicians cautions that the U.S. system of EDs is in "serious condition."

There are no "firm figures" for the recent increase in ED visits, the Times reports. According to the Times, the increase is not affecting all EDs. Some physicians said there has been a recent decline in visits. A report by the American Hospital Association for July, August and September found a slight overall decrease in hospital visits, including ED visits, which resulted from people apparently attempting to avoid spending money on things that are not absolutely essential. However, a 2006 survey found that the number of annual visits to EDs was 120 million, one-third higher than in 1996. According to the Times, physicians in 2006 considered many EDs overwhelmed by the volume, and the recession -- "whose full impact is yet to be seen" -- could worsen ED overcrowding.


EDs often are a less expensive option for uninsured people because the departments legally must treat all patients regardless of their ability to pay, the Times reports. In addition, insured patients who have difficulty obtaining quick access to their physicians -- including older people, who are the fastest-growing population of ED visitors -- are using EDs for care, according to the Times.

Many hospitals are accruing unpaid medical bills. For example, public health system Denver Health experienced a 19% increase in emergency visits by uninsured patients in November, from 2,795 in 2007 to 3,325 in 2008. Denver Health expects the amount of uncompensated care it delivers to increase to more than $300 million this year, compared with $276 million in 2007, according to the Times.

In addition, EDs often attract patients who delay seeking medical help as long as possible and often arrive in conditions that can be worsened by increased wait times and difficult waiting conditions. AHA surveyed its members last year and found at least 200 deaths related to the practice of "boarding," in which patients wait for a bed on stretchers in the ED's halls (Abelson, New York Times, 12/9).

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