- The Washington Times - Tuesday, January 15, 2008

A growing number of visits to the emergency room is leading to longer waits for patients to see doctors, a new study found.

While emergency room visits increased 26 percent between 1997 and 2004, the number of hospital emergency rooms decreased 12 percent, according to a study by Harvard Medical School researchers. The converging trends resulted in an average wait time of 30 minutes to see an emergency department physician in 2004, up from 22 minutes in 1997.

The study is being published today in the medical journal Health Affairs.

“We found that emergency department wait times are getting longer for everyone, especially for those most in need of quick help,” said the lead author of the study, Dr. Andrew Wilper, a fellow in internal medicine at Harvard Medical School. “That means sometimes patients are undoubtedly leaving without seeing a doctor or are discouraged from even coming to the emergency room in the first place.”

The researchers used data from 1997 through 2004 from the National Hospital Ambulatory Medical Care Survey conducted by the U.S. Census Bureau.



The primary contributor to increased wait times is the number of visits, which went up from 93 million to 110 million a year during the time of the study.

Dr. Matt Rice, a member of the board of directors of the National Patient Safety Foundation, agreed with the study’s findings.

“The reality of the emergency department these days is there is more demand than there are resources,” Dr. Rice said. “It’s a complex problem that doesn’t have an easy solution, but needs to be addressed.”

Emergency physicians lamented the nationwide decline in the number of hospital beds.

“This study supports the findings of the daily experiences of emergency physicians. The number of emergency patients is increasing while the number of hospital beds continues to drop. It is a recipe for disaster,” said Linda Lawrence, president of the American College of Emergency Physicians. “National health care reform must strengthen the nation”s emergency departments and provide additional resources for hospital emergency departments.”

A continuing nursing shortage also is contributing to longer wait times, Dr. Rice said.

The U.S. had an estimated 1.89 million registered nurses in 2000, 110,000 short of demand estimated at 2 million, according to the Kaiser Family Foundation, a health care policy research organization in Menlo Park, Calif.

By 2020, the shortage is projected to grow to an estimated 808,400 nurses nationwide.

The study did not research the health outcomes of patients who waited longer to see an emergency room doctor. However, prolonged wait times can have serious implications for the quality of care a patient receives, according to Dr. Wilper.

“We can’t say specifically that more people are dying because of wait times, but other research has shown that patients who wait longer are more likely to leave before receiving care,” he said.

For patients diagnosed in the emergency department with a heart attack, the average wait time increased 150 percent — from 8 minutes to 20 minutes — between 1997 and 2004, the study showed.

“We can make the assumption that people with time-sensitive illnesses are waiting longer, that was the most surprising aspect of the study for me,” Dr. Wilper added.

The Harvard researchers found the longest wait times occurred in urban areas, which account for 80 percent of emergency room visits.

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