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Studies Show Increasing Strain On Emergency Departments

Armen Hareyan's picture

Emergency Departments

Hospital emergency department patient admissions increased by 7%between 1993 and 2003, and several recent studies suggest the abilityof many EDs to treat the sickest patients is "getting stretched thin," Scripps Howard/Wichita Eagle reports. A report published this week in the Annals of Emergency Medicine found that ED visits for people ages 65 and older are increasing the most -- by 26% between 1993 and 2003.

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Mary Pat McKay, an emergency-medicine researcher at George Washington University Medical Center,said, "These patients tend to be sicker and are more likely to beadmitted from the emergency department to the hospital, but with manyhospitals running a deficit of inpatient beds, I don't see where thesepatients are going to go," adding, "Given the needs of this populationand the nature of their medical problems, the current state ofovercrowding is likely to continue to escalate dramatically."

Somehospitals and private companies have established urgent-care andminor-care clinics to handle routine care quickly without anappointment. However, such clinics could further strain EDs by drawingaway patients who have health insurance or the ability to pay out ofpocket for care.

Another study, released last month by the Center for Studying Health System Change,found that difficulty in getting payments from uninsured patientscontributes to a growing reluctance among specialists to work in EDs.The study led by Ann O'Malley, a senior researcher at the center, wasbased on visits to 12 health facilities in representative metropolitanareas across the U.S. The researchers found that payment issues and agreater risk of malpractice lawsuits have led many specialists to opentheir own practices.

Hospitals have tried using incentives toencourage specialists to work in Emergency Departments, but such methods increase costsfor patients and insurers (Bowman, Scripps Howard/Wichita Eagle, 12/9).

Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily HealthPolicy Report is published for kaisernetwork.org, a free service of The HenryJ. Kaiser Family Foundation.