WASHINGTON (AP) - Visits to emergency rooms are
booming even as hospitals are closing, raising fears
that some patients may not get urgent care as fast as
they need it, the American Hospital Association reported
Thursday.
The report comes as no surprise to many cities that
for more than a year have reported ER crowding so bad
that hospitals routinely divert ambulances to competing
emergency rooms. The situation reached a crisis last
winter when ERs around the country overflowed with flu
patients.
But the hospital trade group suggests the crowding
may only worsen because of financial problems. Federal
law requires hospitals to care for patients who come to
emergency rooms. But there is no federal program to
reimburse hospitals for the care of poor, uninsured
people. Additionally, Medicaid reimbursement is low for
emergency services and managed-care plans sometimes deny
payment for ER visits, the report says.
Emergency room visits rose by 15 percent in the
1990s, hitting 99.5 million in 1999, the AHA reported.
One of every five Americans has been to the ER at least
once, visits accounting for 40 percent of all hospital
admissions, the report says.
Yet the number of emergency departments dropped as
493 hospitals, particularly in rural areas, closed
between 1990 and 1999, the report says.
Also, existing hospitals have cut the number of beds.
So if intensive care beds are full, those patients stay
in the emergency room, which can't accept as many
incoming patients - the main reason for ERs diverting
ambulances to other hospitals, the report says. It cited
an informal survey suggesting two-thirds of hospitals
ordered ambulance diversions in the last year.
