Posted on 06/14/2006 9:19:12 AM PDT by NormsRevenge
WASHINGTON - Half a million times a year — about once every minute — an ambulance carrying a sick patient is turned away from a full emergency room and sent to another one farther away. It's a sobering symptom of how the nation's emergency-care system is overcrowded and overwhelmed, "at its breaking point," concludes a major investigation by the influential Institute of Medicine.
That crisis comes from just day-to-day emergencies. Emergency rooms are far from ready to handle the mass casualties that a bird flu epidemic or terrorist strike would bring, the institute warned Wednesday in a three-volume report.
"If you can barely get through the night's 911 calls, how on earth can you handle a disaster?" asked report co-author Dr. Arthur Kellerman, Emory University's emergency medicine chief.
That ERs are overburdened isn't new. But the probe by the IOM, an independent scientific group that advises the government, provides an unprecedented look at the scope of the problems — and recommends urgent steps for health organizations and local and federal officials to start fixing it.
Topping that list is a call for coordinating care so that ambulances don't waste potentially lifesaving minutes wandering from hospital to hospital in search of an ER with room. The idea is to set up regionalized systems that manage the flow much like airports direct flight traffic. That also should direct patients not just to the nearest ER but to the one best equipped to treat their particular condition — making sure stroke victims go to stroke centers, for example.
Other recommendations:
_Congress should establish a pool of $50 million to reimburse hospitals for the unpaid emergency care they provide to the poor and uninsured.
_Congress should ensure that more of the nation's disaster-preparedness funding goes to the hospitals and emergency workers who will provide that care. Typical government grants to hospitals for bioterrorism preparation are $5,000 to $10,000 — not enough to equip one critical-care room. When it comes to getting ready for a bird flu outbreak, few hospitals even have the ventilation equipment needed to isolate patients. And emergency medical services received only 4 percent of the $3 billion distributed by the Department of Homeland Security in 2002 and 2003 for emergency preparedness.
_The board that accredits the nation's hospitals should establish strong guidelines to reduce crowding and ambulance diversion.
At the root of the problem: Demand for emergency care is surging, even as the capacity for hospitals, ambulance services and other emergency workers to provide it is dropping.
There were almost 114 million emergency room visits in 2003, up from 90 million a decade earlier. During the same time, the total number of U.S. hospitals decreased by 703, and the number of ERs by 425. And the total number of hospital beds nationwide dropped by 198,000, as hospitals strive toward more outpatient care — which in turn leaves fewer beds for ER patients to move into when they're seriously ill.
Too often, busy ERs stabilize those patients and then have to leave them lying on gurneys in the hallway for 48 hours or more until a room becomes available and they can be admitted to the hospital. That's not only a time of misery for the patient, but it means less timely care and potentially poorer care, without the specialized equipment and expertise available to inpatients, the report found.
Children have even scarcer help. They make up more than a quarter of all ER visits, yet one survey found only 6 percent of emergency departments had all the supplies needed, such as child-size equipment, to treat them.
Before getting to the hospital, the EMS system — emergency medical services that include ambulances and paramedics — is fragmented. How well-trained and prompt local paramedics are varies greatly; there are no nationwide standards. Many ambulance services can't even effectively communicate with hospitals or other first responders because of antiquated equipment.
The American College of Emergency Physicians called the report groundbreaking but said Congress must heed recommendations to fund the necessary improvements.
Hello, Brick...meet Grand Canyon.
The ER is the portal into our own socialized health system.
The article is an illustration of the principle that once you create a socialist structure, you must continually add regulation, money, and centralization to solve the problems you created in the prior step.
Sore throats,sniffles,light bumps on the head make up a huge percentage of the complaints that bring people to the ER.
Given that the ER in which I worked was far (very far) from the Mexican border,I can't make any proclamations regarding ER's in border states...CA,AZ,TX or in states/cities that have large numbers of illegals.
No mention of illegals... I guess they seldom go.
Topping that list is a call for coordinating care so that ambulances don't waste potentially lifesaving minutes wandering from hospital to hospital in search of an ER with room. The idea is to set up regionalized systems that manage the flow much like airports direct flight traffic. That also should direct patients not just to the nearest ER but to the one best equipped to treat their particular condition — making sure stroke victims go to stroke centers, for example.
We already have this system here, it is called saturation rotation. It works but most of the time the er's are full of non-emergency patients. Our area is overburdened with poor people and illegals who use the er as a doctor's facility. They use ambulances as rides to the hospital. My husband was a firefighter here for 33 years. They always get to any 911 call first, the ambulance follows. He has said that at least 50% of the calls they went on were non-emergencies.
Who do you think pays for all those "rides" to the hospital and hospital visits? Not the people who call.
The problem with them assessing what actually constitutes an emergency....they are afraid of lawsuits. And the emergency law that says they must treat anyone does not actually say what constitutes an emergency. So, they just treat everything, typical.
"Congress should establish a pool of $50 million to reimburse hospitals for the unpaid emergency care they provide to the poor and uninsured"
This is the root cause of this problem. The illegals use the emergency room like a regular doctor and then don't pay for their services.
That HAS to be a typo. Fifty million wouldn't cover the cost of uncompensated care provided by big city emergency rooms on a typical weekend.
The illegals aren't the only ones who use ER's as their primary care physician.
Exactly. As the law now stands, the hospital can't turn anyone away without being evaluated so they all get treated.
Change the law so that every runny nose, sore throat, earache, diaper rash, mild headache, and backache of three month's duration doesn't have to be seen, and there will be a lot more time and resources for the strokes, heart attacks, broken bones, lacerations that need stitching, motor vehicle accidents, and other actual emergency patients.
In Texas - at the Major Hospital in big cities the ER is about 90% full of Latinos or other minorties. Just go and visit one to see for yourself.
Basicaly it is the Free Health Care System of the USA for anyone without insurance. Even if not treated to due non-emergency conditions, all hospitals are atleast required to evaluate anyone who comes in.....
I recall hearing somewhere a few weeks ago that the fed provided $350M to California Hospital emergency rooms for that very reason. I must admit, I cannot find the supporting documentation...
"It's a sobering symptom of how the nation's emergency-care system is overcrowded and overwhelmed, "at its breaking point,"
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Not entirely surprising since illegals use the emergency room as their free walk in medical centers across our nation.
Illegals are a drag on both the economy and the taxpayers of this country.
I agree. The insurance premiums we pay for health insurance are outrageous because the cost of uncompensated care is spread among those who can pay for insurance, and it still isn't enough to cover the costs these people generate for stubbed toes and sniffles in the ERs.
Who do you think pays for all those "rides" to the hospital and hospital visits? Not the people who call.
I can tell you how the other 50% gets to the ER, all at the taxpayer's expense.
A So. Cal RN told me not long ago, that the IA's are taking taxi's to the ER for care.
And you're right, they are not being held responsible for the bill, the local taxpayer is.
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