US Emergency Rooms Decreasing in Number despite Rise in Visits


A recent report reveals that hospital emergency rooms in the US are closing rapidly, especially in poor urban areas. This fact is even more alarming as emergency room visits are rising at the same time. The report was published in The Journal of the American Medical Association. Since 1990, there has been a 25% drop in emergency rooms in suburban and urban areas. In the same time, nationwide emergency department visits have risen by about 35%.

Reasons for the Drop in ERs
Commercial reasons are behind this drop in ERs. They are typically shut down if they cater to too many poor people, or if the profit margins are skimpy, or if they operate in cut-throat competitive markets. Health experts say this development has affected the quality of health care provided in hospitals. ERs in commercial and low-profit hospitals are twice as likely to shut down compared to other hospitals. Safety-net hospitals which serve large numbers of poor and Medicaid patients were 40% more likely to shut shop. ERs in highly competitive markets faced a 30% higher risk of closing down.

Effects of the Closures
Fewer ERs means a longer wait for treatment, which could drastically affect outcomes. In New York City alone, seven ERs have shut down in the last three years. A round-the-clock emergency care center has been planned for the locality of Greenwich Village. But, residents say a mere ER may not suffice their needs, and ask for a full-service hospital. The closures have especially affected residents in New York City. Patients have to travel longer in heavy traffic to get to the nearest ER. They have to wait long hours for treatment, and if they have to be admitted, again they have to wait a long time because beds are not available immediately.

Market Forces Dictate Health Care
The study authors say market forces are playing a large role in health care. This had led to the present situation of inequitable health care. Many doctors are loathe to treat Medicaid patients, who are mostly poor people with a government-sponsored health plan. Such patients turn to ERs for treatment as ERs are mandated by law to provide the required treatment whether or not the patient is able to pay. In this situation, even patients with coverage may not have anywhere to go for prompt treatment, warn health care experts.

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