CDC reports emergency room visits at record high
by James Hubbard, M.D., M.P.H.
Emergency rooms are busy places, sometimes to the breaking point, as anyone who has been there can attest. The CDC has new data on medical care visits, in the U.S., from 1996-2006. The report that is getting the most buzz is the National Hospital Ambulatory Care Survey: 2006 Emergency Department Summary stating that visits to emergency rooms have risen 32 percent (no surprise) at the same time that several hundred ER’s around the country have closed, mostly due to money problems. This report raises concern that facilities are getting stretched to their limit in treating true emergencies in a timely fashion. Their information answers some questions while raising others.
Well over half of patients are seen by a doctor within an hour, with 5.1 percent seen immediately and another 10.8 percent seen within 1-14 minutes. Of the population as a whole, a higher proportion seen in the ER are younger than 1 year or older than 75, African-American, on Medicaid (state medical insurance for the poor) or homeless.
But here’s a surprise! Only 17.5 percent had no insurance of any kind. That is a big monetary drain on hospital resources, but doesn’t seem to jive with the perception that it is mostly the uninsured that use the ER as their primary care home. Rather, it seems, that a significant amount of insureds (including, but not exclusive or Medicaid) go there for “convenience”, or because their primary care provider cannot see them within, what they deem, is an acceptable time. The smallest crowds tend to be around 4-5 A.M. and the largest around 6-7 P.M.
This overall data generally confirms that if you have a true emergency, the emergency room is the place to go. Call an ambulance without hesitation. You will get seen quickly and your problems managed. If you are going for convenience, or so you won’t have to miss work, for instance, you will probably be disappointed because about 20 percent have to wait 2-24 hours for treatment. What about the in-betweens? You should get educated on what is an emergency, such as symptoms of a heart attack or stroke, how to manage cuts, etc. If there is a nurse hotline, use it. If you are in doubt, just go. A triage nurse will usually evaluate you to see if you need to be treat right away or can wait.
Also, there seems to be too few primary care physicians to give patients an alternative. I have blogged on this in the past, but it looks like we should not look to Canada for answers on this. Over-extended physicians there are holding lottery drawings to choose what patients to take.
Have you had to use the emergency room? What was your experience? Do you agree with the conclusions from the CDC? Any suggestions to ease the ER overcrowding? Or do you love to make new friends while bleeding in the waiting room for half the night?
Here is an idea–Get sick at 5:00 A.M.
Tags: health care today
August 15th, 2008 at 11:13 am
Wow. That 17.5 percent number (third paragraph) *is* a surprise, though I’m not sure I would have realized it if you hadn’t pointed it out. Very interesting about the Canadian doctors, too.
This was a great blog entry. I know I’m biased, but really, I learned stuff.
Thanks,
Leigh Ann Hubbard
Managing Editor
James Hubbard’s My Family Doctor