Dive Brief:
- New data from the Centers for Disease Control and Prevention indicates that emergency departments across the US saw a record number of patients in 2011. The agency found that 136 million people visited an ED that year.
- Current CDC projections show ED visits at around 140 million per year, a number which is expected to increase 2.9% each year.
- Particularly in states where Medicaid expansion is driving up ED visits, hospitals are finding it difficult to cope with this rate of growth. Expansion states saw a 5.6% increase in Medicaid ED visits over last year, while EDs in non-expansion states saw an increase of just 1.8%.
Dive Insight:
While ED volumes are likely to continue increasing, hospitals are not prepared for this increase, according to Michael Gerardi, MD, president of the American College of Emergency Physicians. Gerardi argues that hospitals need more resources to cope, especially in Medicaid expansion states. Even at 2011's lower volumes, hospitals were simply hitting their limit. About two-thirds of patients waited two hours or more for beds that year, and 75% of hospitals kept boarding patients even when the EDs were over capacity.
It's not surprising that hospitals are struggling to keep up. After all, the types of patients EDs are treating put big demands on the hospital. For example, the majority of patients arriving with injuries (30% of all comers) were age 75 and older. 60% of patients arrived after normal business hours. Gerardi says that the flood of patients will only grow as more consumers gain coverage under the ACA. And hospitals agree, with almost 90% of those responding reporting an expected increase over the next three years.
Many analysts would like to see flow of patients into the ED slow dramatically, ideally because consumers are insured and so well cared for that they seldom if ever need emergency hospital care. Fiscal policy types would also like to see hospital spared the burden of paying for medically indigent patients who show up in the ED as a last resort. But even if health reform schemes like the ACA work out, they're not going to slow ED usage overnight. Over the next few years, the industry needs to come together to figure out how to cope with this problem, as it seems unlikely that hospitals will be able to do it alone.