Too Many Patients !?!

Visits to American emergency departments have reached a record high of 199.2 million in 2006, according to the “National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary”, published by the CDC (Centers for Disease Control and Prevention) this week. This is an increase of 4 million people coming to emergency departments for care since the previous report from 2005. That’s as if the entire city of Los Angeles went to the emergency department on top of the patients that were already being seen.

Over the past decade, the number of patients coming to the emergency department has increased 32%, from 90.3 million to 119.2 million. Emergency departments are now averaging 227 visits per minute. At the same time, the number of hospital emergency departments has dropped, from 4109 to 3833.

Here are some of the COMMON MYTHS:

It’s because of people being treated for “minor” complaints.

Actually, only 12.1% of the visits were characterized as patients who could wait 2 to 24 hours to be seen. (Nonurgent)

It’s because people without insurance are crowding the emergency department.

Actually, patients WITH private insurance represent the largest category of patients, 39%. Uninsured patients represented 17.4% of the patient pool.

It’s just because the population has grown.

Actually, the population-based ED utilization rate increased by 18%, from 34.2 visits per 100 persons in 2005 to 40.5 visits per 100 persons in 2006.

Here are some HARD TRUTHS:

There aren’t enough beds in the hospitals.

People wait hours and days in the ED after they have been admitted because there is no hospital room available for them. This is called boarding.

There aren’t enough nurses to take care of patients.

According to a report released by the American Hospital Association in July 2007, U.S. hospitals need approximately 116,000 RNs to fill vacant positions nationwide. This translates into a national RN vacancy rate of 8.1%.

There aren’t enough doctors.

Eleven (11) percent of all ambulatory medical care visits in the U.S. occur in the emergency department, and yet emergency physicians represent only 3.3% of active physicians.

As the population ages and as the economic situation worsens, these problems are unlikely to be corrected without purposeful, thoughtful change in the healthcare system.