1 in 3 ERs Forced to Divert Ambulances, AHA Study Finds
One-third of U.S. emergency rooms are so crowded that they must periodically divert ambulances to other hospitals, according to a study released yesterday by the American Hospital Association, the AP/New York Times reports. Researchers with the Lewin Group asked 1,501 hospitals -- about 36% of the country's facilities with emergency departments -- to track their emergency room activity during November 2001. The study found that overcrowding problems were "most acute" at large urban hospitals (AP/New York Times, 4/9). Sixty-two percent of the hospitals surveyed reported that their emergency departments were operating at or over capacity. In addition, 56% of urban hospitals reported diverting ambulances at some point during the month, with that figure rising to 61% among urban teaching hospitals (Smith, Richmond Times-Dispatch, 4/9). Overcapacity problems were worst at New England hospitals, with 52% of facilities reporting their emergency rooms operate beyond capacity, and at West Coast hospitals, where the figure was 44%. The report attributed emergency room overcrowding to the nationwide nursing shortage, an increasing amount of paperwork and a growing number of uninsured patients who use emergency services for primary care (Los Angeles Times, 4/9).
The study concluded that hospital overcrowding probably leads to longer waits for patients, the AP/New York Times reports. The average patient waiting time at a "crowded" emergency room was more than one hour, compared with 39 minutes at hospitals with a "good balance of patients to capacity." The average patient stay at crowded hospitals was 3.7 hours, compared with 2.5 hours at balanced hospitals, the study found. Lack of beds elsewhere in the hospital contributed to emergency room backups; among patients needing hospital admission, those at crowded emergency rooms had to wait about 4.6 hours for an acute- or critical-care bed, compared with 2.2 hours at balanced hospitals (AP/New York Times, 4/9). The Los Angeles Times reports that the study suggests "many emergency rooms are unable to handle even the day-to-day stresses" of emergency care (Los Angeles Times, 4/9). Carmella Coyle, AHA's senior vice president for policy, said, "Emergency department overcrowding itself is a symptom ... of a health care system that's broken" (AP/New York Times, 4/9). The full survey is available online. Note: You must have Adobe Acrobat Reader to view the survey.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.