More people are going to the emergency rooms and many of them are elderly and often repeat users, according to a study published online today in the Annals of Emergency Medicine.
The study, "The Changing Profile of Patients Who Used Emergency Department Services in the U.S.: 1996-2005," found that patients using emergency rooms increased nearly 9% between 1996 and 2005.
The researchers wrote "EDs play a larger role in the management of geriatric patients over time. The increasing burden of the aging population in the EDs poses challenges in the training of future emergency physicians, care for older patients, public health insurance, and healthcare system reform."
"Growing numbers of elderly and chronically ill people are visiting the emergency department, and many of them are visiting multiple times in a year," said lead study author K. Tom Xu, PhD, of the Department of Family and Community Medicine at Texas Tech University Health Sciences Center in Lubbock, Texas. "Furthermore, patients who visit the ER three or more times a year increased 28% in just three years, from 1999 to 2002. We saw increases among blacks, the elderly, patients with two or more types of health insurance, and patients in poor health. There was a decrease in visits for the uninsured."
The number of non-institutionalized people who visited the ED increased from 34.2 million to 40.8 million, which represents 13.8% of the U.S. population, according to the researchers.
Researchers said the study shows that the common belief that the uninsured are flooding the country’s emergency rooms is not correct.
"Our study confirms that the poor and the uninsured are not the main contributing factors to emergency department crowding in recent years," said Xu. "The burden on emergency departments of caring for elderly patients has increased a lot in the last decade. Our aging population will create additional challenges in the training of future emergency physicians and in healthcare reform overall."
Because they found that the poor and uninsured are not the "main contributing factors for ED crowding," researchers suggested that future health policies that look to improve ED access for the poor and uninsured would have "limited effects."
"In contrast, better management of geriatric patients, who are likely to have a constellation of chronic disease, may produce better results. In terms of cost containment and disease management of patients, the relationship between primary and ED care perhaps is more similar to that between primary and specialist care than we previously thought, especially as the proportion of the elderly population in the U.S. increases. Ways to achieve efficient chronic disease management, disease prevention, and health promotion at the primary care level are critical in the pursuit of the solution for ED crowding and utilization," researchers wrote.
This increase in ED users could further complicate the issue of delays in EDs. Another study that appeared in Annals of Emergency Medicine earlier this week called "United States Emergency Department Performance on Wait Time and Length of Visit" found that only 30% of EDs got the majority of their patients seen by a physician within recommended time frames, and 13.8% of EDs achieved the triage target for the majority of patients who needed to be seen by a doctor within an hour.