A new Harvard study shows patients are waiting in emergency rooms longer each year to receive treatment, particularly those who are most severely injured. The study analyzed the time between when patients arrived in the emergency room and when they were first seen by a doctor. The study found emergency delays affect all walks of life, regardless of race or insurance status.
Emergency Room Delays Increased For Most Seriously Injured
Perhaps most disturbing, the study shows that patients with the most severe injuries suffered the largest increase in emergency room waits. Between 1997 and 2004, the average wait time to see a doctor increased 36% for all emergency room patients (from 22 minutes to 30 minutes). However, for patients who were classified as needing immediate attention, the wait time increased 40% (from 10 minutes to 14 minutes). Worse still, the wait for heart attack patients increased by 150% (from 8 minutes to 20 minutes) with a quarter these patients waiting 50 minutes or more before seeing a doctor. The "ever-lengthening waits are a frightening trend because any delays in care can make the difference between life an death for some patients," says Linda Lawrence, President of the American College of Emergency Room Physicians. (See Washington Post, Jan. 15, 2008)
ER Patients Are Not Profitable For Hospitals, Says Harvard Researcher
The Harvard study also found the number of emergency room visits increased from 93 million in 1994 to 110 in 2004. At the same time, the number of 24 hour emergency rooms decreased by 12% from 1994 to 2004. Lead author of the Harvard Study, Dr. Andrew Wilper, observed emergency rooms close "because, in our current payment system, emergency room patients are money losers for hospitals. Planned admissions of elective patients who need procedures are usually more lucrative for two reasons. First, elective patients can be scheduled more conveniently and efficiently, and second, they can be pre-screened for health insurance. Our study suggests that these perverse incentives are causing dangerous delays in potentially life-saving emergency care, even for those with insurance."
Dr. Steffie Woolhandler, co-author of the study, remarked that "some policy makers claim that everyone in America has access to health care through the [Emergency Room]. Our findings counter this notion. We have insurance company CEOs making tens of millions of dollars per year, 47 million uninsured Americans, and worsening access to emergency care for everyone. Something is wrong here."
If hospitals are willing to compromise emergency room care because these patients are not profitable, they should not be surprised when a family brings a medical malpractice claim because their loved one unnecessarily died in the emergency room waiting for care.
Emergency Rooms are at a Breaking Point
In 2006, the Institute of Medicine, a unit of the National Academy of Sciences, warned that U.S. emergency rooms were at a breaking point. The Institute concluded the U.S. emergency system was overburdened, under funded, and highly fragmented. The Centers for Disease Control and Prevention separately found that between 40% and 50% of emergency rooms experienced overcrowding in 2004.
Nearly Everyone is Affected by Delays in the ER
As nearly every American has been to the emergency room at one point in their life, we are all susceptible to the problems these delays can cause. One thing critically ill patients could consider is calling 911 rather walking into the emergency room on their own. Patients who arrive by ambulance will usually be seen sooner by a doctor than patients who check themselves in at the triage desk. Of course, calling 911 should only be reserved for true emergencies.