An analysis by researchers at the Cambridge Health Alliance and Harvard Medical School found that the median waiting time to see a physician in hospital emergency departments jumped from 22 minutes in 1997 to 30 minutes in 2004, a 36% increase.
Ominously, according to results published in the journal Health Affairs, wait times more than doubled for the sickest heart attack patients. In 1997, half of them got to see a doctor within eight minutes; in 2004 it took 20 minutes. For a quarter of the heart attack patients, the wait reached 50 minutes or more – a particularly disturbing lag because chances of surviving a heart attack are known to worsen when treatment is delayed.
Such improper care can be grounds for a claim under the federal Emergency Medical Treatment and Active Labor Act (EMTALA). Under the EMTALA, a hospital and doctor must follow the standard screening practices of the hospital to attempt to identify an emergency medical condition for all patients presenting to the hospital. Failure to make such a proper and timely screening may constitute a violation of the EMTALA. Patients can base claims for their injuries on this statute in addition to medical malpractice grounds.
Thus in addition to paying traditional compensation for pain and suffering and other losses, hospitals and doctors can be subjected to governmental investigations and fines caused by not properly screening or stabilizing patients.
The researchers attribute the longer waits primarily to an increase in the number of emergency room visits coupled with the closure of many emergency rooms. The number of Emergency Department (“ED”) visits increased from 93.4 million in 1994 to 110.2 million in 2004. Meanwhile, the American Hospital Association reports that the number of hospitals operating 24-hour EDs decreased by 12% between 1994 and 2004.
ED crowding in the remaining EDs causes one ambulance to be diverted away from a U.S. ED every minute, according to the National Center for Health Statistics. Both the increase in ED visits and the decrease in 24-hour EDs are driven by the lack of universal health coverage. Uninsured patients – and those who have no primary care doctor – go to emergency rooms for routine coverage, clogging the system. Many hospitals are either short on beds or have decided to allocate many beds to patients who pay top dollar for elective care.
The study, which analyzed the time between patients’ arrivals in the emergency department and when they were first seen by a doctor, found that the increasing delays affected everyone, including those with and without health insurance.
Patients of all racial, ethnic, and socioeconomic status are facing ever-increasing waits for care in emergency rooms. Steffie Woolhandler, Associate Professor of Medicine at Harvard and study coauthor,said: “Some policy makers claim that everyone in America has access to health care through the ED. Our findings counter this notion. We have insurance company CEOs making tens of millions of dollars per year, 47 million uninsured Americans, and worsening access to emergency care for everyone. Something is wrong here.” Somebody should tell that to President George W. Bush.
The Institute of Medicine, a unit of the National Academy of Sciences, warned two years ago that the nation’s emergency rooms were at a breaking point. It called for better systems to route patients to the least crowded emergency rooms and an infusion of money to bolster emergency care.
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