Study addresses Emergency Room crowding

The University of Michigan recently performed a meta-analysis of 127 separate studies addressing various topics and extrapolated information relative to why ERs are over-crowded.  Their findings were reported in the Journal of the American Medical Association.  Researchers found that the uninsured made up 17 percent of all visits and that some of these visits were for routine "non-emergent" care that should have been provided by a primary care physician.  It found, however, that the uninsured did not misuse ERs in this manner very frequently, probably because they knew they would receive a substantial billing.  If any group tended to over-utilize the ER for primary (non-emergent) services, it was persons with public insurance like Medicare and Medicaid.

Other causes for over-crowding were a shortage of primary-care physicians; the closure in some locations of Emergency Rooms, leaving the population under-served; a shortage of beds within institutions for lateral movement of patients, and a general financial stress on the emergency medical infrastructure.  As we have previously reported on this site, the over-crowding of Emergency Rooms has lead to significant delays in the triage, assessment, diagnosis and treatment of all patients, including those with truly emergent problems (and private insurance).

As an aside, 45 million Americans--or about one in seven--are uninsured.  Recent studies (also identified on this website) have graphically demonstrated that lack of insurance causes people with serious medical problems to avoid or delay care to such an extent that statistically they have mortality and morbidity rates significantly higher than the insured population.  They also are billed substantially more for their care than are patients whose insurers have negotiated discounted rates.