Emergency Rooms In Critical Condition

(CBS)  The emergency room has become a waiting room, according to a study of more than 90,000 ER visits.

"My mother was seriously ill for a couple of years and I frequently had to take her to the hospital and we were often waiting three, four, five, six hours," Donna McCormick told CBS News medical correspondent Dr. Jon LaPook reports.

A report found emergency room waiting times have increased 36 percent since the 90s, from an average of 22 minutes in 1997 to 30 minutes in 2004.

The wait has hit heart attack patients the worst, increasing their average wait from 8 minutes in 1997 to 20 minutes in 2004.

"Patients who are arriving at the emergency department with time sensitive illnesses may not be receiving the care that they need given these longer waits," said Dr. Andrew Wilper of the Harvard Medical School.

Why? The number of ER visits has increased, and the number of emergency rooms has decreased.

Dr. Assaad Sayah of Cambridge Health Alliance explains: "Because of hospital closures, the number of in-patient beds nationwide has shrunken. While at the same time our population is getting older, requiring more patient care and they are getting sicker."

Cambridge Health Alliance hospitals have been able to reduce waiting time 18 percent over the last six months, through steps like better scheduling of elective surgery. But making hospitals more efficient is not enough.

Improving care inside the emergency room depends on solving a major problem on the outside. With 47 million Americans lacking health insurance, the ER has been taking the place of the primary-care doctor.

[snoopy28173]

So all Medicaid paitents come into the ER when there is no emergency? I don''t think so. I''m on Medicaid/Medicare and only go to the ER when there is a legit emergency and I probably wait to long to go in anyhow. I don''t wear tacky clothes and have unkempt hair. Don''t stereotype those on Medicaid. I have a Bachler''s degree. I just can''t work due to illness and due to multiple pre-existing condations, there is no way other insurance would cover me.

[robjk1-2009]

I work in an ED and one of the big problems is the cluster of people that come when it''s not and emergency and it''s usually the ones on medicaid or have no insurance at all. It backs up the ED causing longer waits and less care for the ones that truely have an emergency.

I usually can guess if on medicaid (if any ins.) by what they came in for.

[cucbn]

We pay 2.5 times what other countries pay because the people that are paying are paying for the others that aren''t as well as for themselves, as well as the reasons stated by LChristRN1. The answer is somewhere between the solcialist model and the model we have now. Additional regulation is required. As far as I''m concerned, anyone presenting with a life threatening emergency, be they old, illegal, or otherwise, should recieve treatment. I fully agree with legislation requiring employers to provide workers'' compensation to illegal aliens. I do not endorse emergency rooms being catch all health care facilities for the uninsured. The majorty of people that complain in my ER are getting free healthcare - but they are still unwilling to wait more than an hour to be seen for "cough and cold symptoms x 4 days". Education would be a great start - changing our societies need for instant gratification would be nice too. But I fully disagree with a system that says everyone gets treated equally no matter what they can put into the system.

[venkata4--2008]

"This has been a problem for a long long time. It''''s not going away and throwing stones at those who do not have medical care is NOT the answer. The system is broken and has been broken for some time. We spend MORE per person for health care and get less in return than any nation on the planet. THAT says it all. Add that to the fact that those who must care for the sick are over worked and under paid and you have some folks getting awlful rich on our misery.

Posted by skyk at 06:52 AM : Jan 16, 2008"

I agree with you. Particularly infants/toddlers & kids developing late Friday evening symptoms of sick ness, you have no where to go except ER. I work on weekends if I get paged. If you page doctor''s they call back and symptoms require immediate assistance they direct you to ER where you tend to wait 3,4 hours for a nurse take vitals. Why cannot doctors come to clinic to work on weekends/after hours. That can also reduce ER visits. I do not get it.

[barbaraf4]

Triage is the only way to go. I suggest prioritizing the patients in this sequence: 1. immediate life threatening, 2. those who have health insurance, 3. everybody else.

[schildme]

Hospitals need to make changes to the part of the equation that is under their control%u2014the ED. THERE IS A SOLUTION!!! Emergency Departments can be improved by using the principles of Lean (from manufacturing). Emergency registration, triage and care processes can be streamlined to improve efficiency by eliminating wasted steps in the ED. Results will show improved flow of information, patients, and staff as well as free up valuable resources. It%u2019s a win-win situation for medical facility as well as the patient.

[lchristrn1]

I work in an ER in Florida. 1)Currently 65% of our patients do not pay for hospital services. Half of which are illegal aliens. We currently provide mostly family practice care and not emergency room services. 2)The biggest "complainers" are welfare recipients. What I don''t understand is that they get free money, food and healthcare. Why would complain about something that you have been given for free? 3)ER physicians are ordering tests and labs that aren''t needed because they don''t want to be sued by the patient. The general public expects the ER to diagnose everything even though they don''t follow-up or even see a primary care doctor. 4)Lastly, the nursing shortage is also a major factor. When there are not enough nurses working on the floors and in the critical care units, the ER cannot move patients out of rooms. This causes a major backlog in the ER. With all of these factors, it is no wonder the medical system is broken. The wait times are predicted to get even longer as the years go by. I personnaly don''t know if I will be able to continue taking care of patients. I have been assaulted 4 times (I once ended up with a broken foot), get cussed out daily by patients, have had rocks thrown at my car, and have had death threats made against me because people do not want to wait even though they don''t have an emergent complaint. I don''t know what the answer is, the only thing I do know is that a lot of the large buildings in any downtown area are owned by insurance companies.

[alphaa10-2009]

cucbn said, "... healthcare managers in Cuba are not going to report numbers that would make them, or Cuba, look bad... Here someone might get penalized, then be able to sue the agency they reported on under wistle-blower''''s protection... socialism is not an improvement over democracy."
---
Sorry to disappoint you, but Bush ushered through legislation that prevents most whistleblower protection.

Further, you have no assurance healthcare data is reported any more accurately here than in Cuba. If anything, HMO scandals of late demonstrate a breakdown in accountability.

Socialism and democracy are not opposed concepts, so your usage is completely off track-- unless you meant some hoary myth like, "In America, the marketplace always brings consumers what they want." We would not have 47 million Americans under- or uninsured, if the "marketplace" were as effective as Adam Smith proposed.

[rudy654-2009]

Socialized medicine is the ULTIMATE HMO...you people don''''t know what you''''re asking for. As with VA/Military healthcare, the government needed to run large healthcare programs slows things down and decreases overall quality of health. Posted by cucbn at 01:13 AM

It seems to me that Dikc Cheney is liking his government provided health care just fine.

[rudy654-2009]

Posted by cucbn at 01:23 AM

Why the hecck are you comparing our health system with that of Cuba''s? Compare it with the rest of Western World. No one in those countries is trying to get over hear because they think we have it better with health care. I remember a fellow from Germany and I asked him why he didn''t try becoming a US citizen. He didn''t want to risk losing health care. He could always return to Germany if he got sick. Here, he would have to hope that his employment would provide it for him.