Death and Dying and the Economics of ER Care
Such tragic deaths happen every day in U.S. hospitals…. a crowded ED is more than a nuisance; it is a threat both to individual patients and to overall public health. Still, the financial imperatives of hospital operations trump patient safety. The GAO has noted that many hospital administrators tolerate ED crowding and even divert inbound ambulances rather than postpone or cancel elective admissions.
The passage of the Affordable Care Act may actually make stories like my mother’s more common, as 32 million more Americans seek access to an emergency care system that is already overwhelmed.
Those of us who have dedicated our careers to health care must confront the fact that our inability (or, more likely, unwillingness) to reduce the waits and delays that bedevil emergency care is harming and even killing our patients.
Entire New England Journal of Medicine article is worth reading.
Depressing. Can’t you post some happy news once in a while.
Emergency Departments are usually money-losers since many of the people that come through the ER doors cannot pay for the care they receive. During the past decade a significant number of hospital ERs have closed. If we truly want a system where people in dire need of emergency care have access to that care, we will have to redesign our health care system so Emergency Departments are not providing both emergency and primary care.
This may be an example of market failure.
The overcrowding of emergency rooms has come about to some extent, because uninsured people get their care through emergency rooms, where they cannot be refused. As a result hospitals have closed emergency rooms, which do not enhance their bottom line, making the problem of crowding even worse.
http://jama.ama-assn.org/content/305/19/1978
The idea that the Health Care Reform Act would make the problem more acute which is what John Maa has suggested seems to be wrong. Better access to insurance and primary care should reduce pressure on emergency rooms.
Wow. That story really touched my heart. I work in health care field and see that many patients have been in the Emergency Rooms for hours.Some hospitals have now created websites that you can schedule when you are coming to the ER to decrease wait times, but even this seems like a strange idea. I wonder how can you predict what time you are going to go to the Emergency room, if it is a true emergency. Another thing I have seen is the some people that come through the emergency room use it as a quick fix. I say this because they do not have health insurance and have chronic diseases that are not managed. I agree that if more people were insured it would help with the overcrowding in the emergency rooms.
There are many factors that could have played into this problem: prioritizing elective admissions over emergencies, the misuse of the emergency room by the public, inadequate turn-over time for inpatient rooms, miscommunication, and lack of available procedures on nights and weekends. All of these factors also have many factors that ultimately led to a lost life. As a nurse, this article encourages me to take ownership of my job and to view everything that I do, including the small details, as part of the bigger picture of saving lives.
I agree Laura it is an eye opener and makes me more aware as a nurse of a bigger picture.