Seniors lead the growing rush to hospital ERs

Trips to hospital emergency rooms continue to go up, 7 percent in the last decade.

But several recent studies suggest that the ability of many ERs to treat the sickest patients is getting stretched thin.

For one thing, many people are coming in with more serious problems, particularly the elderly.

A report published this week in the Annals of Emergency Medicine notes that the visit rate for seniors, 65 and older, increased faster than any other age group between 1993 and 2003, 26 percent.

“Given the needs of this population and the nature of their medical problems, the current state of overcrowding is likely to continue to escalate dramatically,” said Dr. Mary Pat McKay, an emergency-medicine researcher at George Washington University Medical Center in Washington.

“These patients tend to be sicker and are more likely to be admitted from the emergency department to the hospital, but with many hospitals running a deficit of inpatient beds, I don’t see where these patients are going to go.”

The report concludes that emergency-room visits for patients between 65 and 74 could nearly double by 2013.

“Just continuing the trend over the next few years could cause the emergency-care system to collapse,” McKay said. “Patients are already boarding in hallways, sometimes for as long as several days. I could see patients waiting in the street because there just isn’t any more room.”

ER crowding continues despite efforts by many hospitals and private companies to set up new urgent-care or minor-care clinics around the country to handle routine care more quickly without an appointment. Many family-doctor groups are also taking steps to make it easier for patients to get in the door for same-day care.

Another study, released last month by the Center for Studying Health System Change, suggests that difficulty in getting payment from uninsured patients is one reason for a growing reluctance among specialist doctors to be on call for emergency-room cases.

“The traditional role of physicians taking emergency-call duty as part of their obligation for hospital admitting privileges is unraveling across the country, posing risks that insured and uninsured patients alike may not get timely and appropriate care,” Dr. Ann O’Malley, a senior researcher and co-author of the study, said.