Emergency Department Wait Times Increased

Armen Hareyan's picture
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Wait times for emergencycare across the U.S.increased from 1997 to 2004, especially for heart attack patients, according toa study published online on Tuesday in the journal Health Affairs,USA Today reports (Davis, USAToday, 1/15). For the study, lead author Andrew Wilper, a fellow ininternal medicine at Harvard Medical School and a physician at Cambridge Health Alliance, and colleagues used patient visitand wait time data collected between 1997 and 2000 and between 2003 and 2004from the NationalHospital Ambulatory Medical Care Survey (Lee, Washington Post, 1/15). The researchers analyzeddata on more than 90,000 emergency department visits.

According to the study, the number of ED visits increased during the studyperiod from 93.4 million to 110.2 million, and 12% of 24-hour EDs closed duringthe study period (USA Today, 1/15).

The study found that:

  • The median wait time before seeing a physician for all ED patients was 30 minutes in 2004, a 36% increase from 22 minutes in 1997;
  • Patients whose condition merited treatment within 15 minutes waited 14 minutes or more in 2004, compared with 10 minutes in 1997;
  • The median wait time for heart attack patients was 20 minutes in 2004, up from eight minutes in 1997 (Washington Post, 1/15);
  • About 25% of heart attack patients in 2004 waited 50 minutes or more for emergency care;
  • Women waited 5.6% longer than men for treatment (USA Today, 1/15);
  • Urban hospitals' wait times were twice as long as those in rural hospitals;
  • Not-for-profit hospitals had wait times 13% longer than private hospitals; and
  • The Northeast had the longest wait times of any region in the U.S. (Francis, Wall Street Journal, 1/15).

The authorsdid not determine the cause of the wait time increases (USA Today,1/15). Wilper said that it is unclear why heart attack patients saw higherincreases (Wall Street Journal, 1/15).

Disparities

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The study also found disparitiesin wait times between whites and racial and ethnic minorities. Black patientswaited 13% longer than non-Hispanic whites. In addition, Hispanics waited 14.5%longer than whites (USA Today, 1/15). The disparities remainedeven when researchers adjusted for age and hospital location. Wilper said thatthe disparity might be caused by "little decisions along the way" byED staff. He also said that hospitals that serve minority patients might havelonger wait times in general (Wall Street Journal, 1/15).According to researchers, minority patients often are treated in urbanhospitals, which are more likely to be overcrowded than rural hospitals (WashingtonPost, 1/15).

Comments

Wilper said, "Patientswho present to the emergency room with time-sensitive conditions may be harmedbecause they're not receiving the care they need in a timely way" (Grant, Houston Chronicle, 1/15). He added, "That means sometimespatients are undoubtedly leaving without seeing a doctor or are discouragedfrom even coming to the emergency room in the first place."

Matt Rice, a member of the board of directors of the National Patient Safety Foundation, said, "The reality of the emergencydepartment these days is there is more demand than there are resources,"adding, "It's a complex problem that doesn't have an easy solution butneeds to be addressed."

American College of Emergency Physicians President Linda Lawrence said,"This study supports the findings of the daily experiences of emergencyphysicians. The number of emergency patients is increasing while the number ofhospital beds continues to drop. It is a recipe for disaster." Lawrence added,"National health care reform must strengthen the nation's emergencydepartments and provide additional resources for hospital emergencydepartments" (Lopes, Washington Times, 1/15).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.

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