ERs Face Problems Despite Economic Boom
Despite a decade of economic prosperity, the United States now has fewer emergency rooms that it had in the early 1990s, and evidence suggests that emergency room care is "worse" today than it was in the early 1990s, the Los Angeles Times reports in the second part of a two-part series on "Private Prosperities, Public Breakdowns." In the last few years, many emergency rooms periodically have declared themselves "overwhelmed" and diverted ambulances to other hospitals. Other hospitals are so full that ER doctors cannot find rooms for patients who need to be admitted, a situation likely linked to a "huge decrease" in the number of intensive care unit beds over the last 10 years. The situation not only affects the poor, who traditionally have relied on ERs to provide care, but also "almost anybody who suddenly takes ill or sustains a traumatic injury." Dr. Arthur Kellermann, chair of emergency medicine at Emory University, said, "How can we spend such an astronomical amount of money on health care and still not have enough emergency rooms?" A "key force" behind this "crisis" is that the United States "has relied ever more heavily on the private sector rather than on government regulation" to determine how the nation's health system works, medical analysts say. There are myriad other factors contributing to the problem, such as reduced reimbursements from managed care companies, "swelling" ranks of the uninsured, an aging population and a "severe shortage of nurses," the Los Angeles Times reports.
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.
Particularly "vexing" to medical specialists is that the current situation "comes not just after a long period of prosperity but after several years in which it appeared that the nation's ER problems were on the verge of solution," the Times reports. In the early 1990s, people coming to the ER without a means to pay for treatment was the "insurmountable" problem. Although the payment problem was not resolved, overcrowding "suddenly began to ease in the middle of the decade." The Times reports that the problem now lies in the "huge drop" in the number of intensive care unit beds, which makes it "extraordinar[ily] difficul[t]" for ER doctors to move patients out of the ER and into the hospital. Several hospitals are working to make changes to improve ER care, such as Massachusetts General Hospital, which has added several ICU beds. But many government and medical officials say that repairs being made to ER systems are "little more than stopgap measures," adding that a "galvanizing event" is necessary to spur more substantial changes (Gosslein, Los Angeles Times, 8/6). The first part of this series, which focuses on how the 1990s economic boom affected society in general, can be found at http://www.latimes.com/news/nationworld/nation/la-080501private.story.