More Visitors, But Fewer ERs

More people are seeking care in U.S. hospital emergency departments in the last decade but there are fewer departments to treat those in need, federal officials said Wednesday.

Emergency department visits increased by 20 percent in 2001 (107.5 million visits) compared to 1992 (89.8 million visits), the Centers for Disease Control and Prevention said.

Yet emergency departments have shrunk by 15 percent during the same time period because of hospital closures, mergers or lack of profitability, said study author Linda McCaig, a CDC health scientist.

As a result, more patients have sought help in the remaining emergency rooms still open. That's resulted in longer waits for non-urgent care and more ambulances diverted to other hospitals, McCaig said.

"There are a lot of problems with emergency department care right now with the overcrowding and ambulance diversion and concern about quality of care," McCaig said. "It's important to monitor."

A March report from the federal General Accounting Office said two-thirds of emergency departments reported going on diversion at some point during 2001 and nearly 1 in 10 hospitals were on diversion 20 percent of the time.

The increase in U.S. emergency room visits comes from the country's aging population. Older people have "more chronic conditions and they visit the emergency department more often," McCaig said.

Also, frustration with health insurance policies may be prompting more visits.

"It seems that people may have more trouble with scheduling appointments with a primary care provider in a timely fashion," McCaig said. "They might find it more convenient to go to the emergency department where they can get same-day service."

More than half of the visits were for urgent care, including heart attacks, stroke, trauma cases, asthma and fractures.

By Daniel Yee