Harvard Study Finds Dangerous Increase in Emergency Department Waits Nationwide
January 16, 2008 - Waits for emergency care are getting longer each year, according to a study published online this week by 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 increasing delays affected everyone, including those with and without health insurance, and people from all racial and ethnic groups.
Severely ill patients suffered the largest increases in ED waits, according to the study. Between 1997 and 2004, waits increased 36 percent for all patients (from 22 minutes to 30 minutes, on average). However, of those whom a triage nurse classified as needing immediate attention, waits increased 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 increase. A quarter of heart attack victims in 2004 waited 50 minutes or more before seeing a doctor.
The research, carried out at the Cambridge Health Alliance/Harvard Medical School, is the first detailed analysis of national trends in ED waits. Using data from the National Center for Health Statistics (NCHS), the authors analyzed over 90,000 ED visits nationwide between 1997 and 2004.
While all demographic groups experienced lengthening ED waits, waits 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 percent longer than men), while rural hospitals' patients had the shortest waits.
The number of ED visits increased from 93.3 million in 1997 to 110.2 million in 2004. Meanwhile, the American Hospital Association reports that the number of hospitals operating 24-hour EDs decreased by 12 percent 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.
For more information: www.pnhp.org and www.healthaffairs.org