ED Waits Lengthen, Compromising Care and Tempting the Devious
Ever consider calling an ambulance to get the express lane to emergency care rather than driving to the ER and facing hours of moaning in purgatory, oops, I mean the waiting room? Such thoughts are blatantly wrong and would be an abuse of the system. Still, I can see the appeal-especially after experiencing both situations over the last few years (ambulance and immediate attention for internal bleeding, and self-transportation with a grueling four-hour wait for a high-grade fever due to suspected Lyme disease).
Unfortunately, more people may face the unhealthy temptation to skip to the head of the line with the recent news that waits for emergency care are expanding each year, according to a Harvard study released Jan. 15 in the journal Health Affairs. The study, which analyzed the time between a patient's arrival in the emergency department (ED) and when they were first seen by a doctor, found that the widening delays affected everyone, including those with and without health insurance, and people from all racial and ethnic groups. The study involved more than 90,000 ED visits nationwide between 1997 and 2004. Here's a recap of results:
- Severely ill patients suffered the largest increases in ED waits.Between 1997 and 2004, waits increased 36 percent for all patients-from 22 to 30 minutes on average.
- For those whom a triage nurse classified as needing immediate attention, waits soared by 40 percent (from 10 to 14 minutes).
- Waits increased the most for emergency patients suffering heart attacks, who waited only eight minutes in 1997, but 20 minutes in 2004, a 150 percent jump. A quarter of heart attack victims in 2004 waited 50 minutes or more before seeing a doctor. (It doesn't take a heart surgeon to know that such delays seriously mar chances of survival.)
- While all demographic groups experienced greater ED waits, they were slightly longer for blacks (13 percent longer than non-Hispanic whites) and Hispanics (14.5 percent longer). Women also had longer waits (5.6 longer longer than men), while rural hospital patients had the shortest waits.
It's hard to believe that the study, conducted by the Cambridge Health Alliance/Harvard Medical School, Boston, is the first detailed analysis of national trends in ED waits. But rather than complain, I applaud the researchers for bringing awareness to this dangerous situation, so solution-oriented steps can follow. I also vow to never call for an ambulance unless truly needed-I'll just pack War and Peace for the waiting room.