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Emergency Rooms in Crisis: Diversions or Ambulance Bypass on the Rise

Fri March 14 2008 8:01 am
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In Chicago they call it “Bypass” in New York they call it “Diversion.” Whatever they call it, experts say it is sign of the emergency medical system in trouble.

The practice of diverting ambulances from overcrowded emergency rooms has become widespread — and the delay in treatment can have fatal consequences.

Consider these medical statistics:

— One ambulance per minute is diverted or bypassed from the nearest hospital —  500,000 ambulance diversions per year. Source: Institute of Medicine of the National Academies.

— In 2000, Columbia University in New York City found that fatalities from heart attacks increased by as much as 47 percent as a result of diverting ambulances.

— In Houston, Texas, the average rate of diversion was 14 percent in 2001. Today, the rate is 40 percent. Source:  Dr. Guy Clifton, a professor of neurosurgery at the University of Texas in Houston.

— Americans are using emergency rooms more than ever in today’s society. In 2005, 115 million Americans went to the ER, up five million from the year before. Source: Centers for Disease Control.

— Between 1994 and 2004, there was a 20 percent increase in the demand for emergency care, according to the CDC, which is most likely due to an increase in the nations’ uninsured and growing elderly population.

During those years, 9 percent of the nation’s ERs closed, having lost money from inadequate reimbursement, according to the CDC.

— A recent Harvard study found the average waiting time for a patient to see a doctor in the ER jumped from 22 minutes in 1997 to 30 minutes in 2004. The same study showed patients with coronary episodes waited 8 minutes in 1997; in 2004, they waited 20 minutes.

— Of 1,000 doctors polled by the American College of Emergency Physicians last year, 200 said they knew of a patient who died because of failure to deliver prompt care in an overcrowded emergency department.

Many people also abuse the system by calling paramedics for non-emergency calls, like headaches, diarrhea, or simple frost bite.

In Arlington Heights, Illinois many ambulance calls by emergency paramedic ambulances are used to transfer residents from extended care facilities to the hospital. Emergency paramedic ambulances are also busy treating and transporting homeless people who are often found passed out, drunk on warm ventilation grates near sidewalks of commercial buildings.

Combine these factors and the emergency medical system is near a crisis stage.

Bellevue Hospital Center, the nation’s oldest public hospital, treats many of New York City’s disenfranchised residents. Few of these patients can afford private doctors.

One cause of emergency department gridlock is the practice known as “boarding.”

Admitted patients are left in the emergency department for extended stays until hospital beds become available — and patient care suffers.

The American College of Emergency Physicians supports Congressional passage of the Access to the Emergency Medical Services Act. This bill would recognize the need for more money to sustain an ailing system that must provide care to everyone, including those who can’t pay by creating a national bipartisan commission to examine the delivery of care in the nation’s emergency departments.

The act also calls on the government to collect data on the widespread practice of boarding so that new guidelines can be applied. A vote on the bill is expected by April.

See also …
FOXNEWS.COM : Emergency Rooms in America: A Deadly Prognosis

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