May 9, 2001 (Washington) -- Americans sometimes boast that we
have the best healthcare system in the world, but several disturbing trends are
highlighting some critical weaknesses.
Emergency room overflows, which force ambulances to be
redirected to other hospitals, are becoming common year-round in cities around
the nation, says a report released Wednesday from the nonprofit Center for
Studying Health System Change.
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Meanwhile, a current nursing shortage may already be hampering
healthcare and forecasting dire possibilities for the coming explosion in the
According to the new report, demand for ER services has grown,
partly as HMOs more loosely manage visits, thanks to the consumer backlash
against managed care. At the same time, however, health industry factors such
as hospital mergers have cut the number of ER facilities, even as an ongoing
nursing shortage threatens hospitals' ability to staff their beds.
The center's findings are based on in-depth visits it conducted
to 12 communities around the country.
Managed care firms are under pressure to keep access to
emergency rooms relatively open, but hospitals are squeezed enough financially
to try to save money in their nursing operations, says Paul Ginsburg, PhD,
president of the center.
"Hospitals always find it much more difficult to affect how
physicians practice in the hospital, than to squeeze the services directly
under the control of the hospital administrator," he tells WebMD.
Earlier this week, an international survey of nurses revealed
widespread dissatisfaction and concerns over patient safety within the health
system. Fewer than 20% of nurses in the U.S. are younger than 30, and one-third
of these nurses reported that they intended to leave their jobs within a year.
Meanwhile, two-thirds of nurses said there were not enough nurses in their
hospitals to provide adequate care to patients.
Sean Clarke, RN, a researcher with the University of
Pennsylvania School of Nursing and a co-author of the nurse survey, tells
WebMD, "Physicians in some areas are already finding that surgeries have to
be cancelled because there aren't nurses to look after the patients once they
come out of the surgery." He warns, "The nursing shortage has the
potential to cause real problems and to decrease the quality of care available
in the U.S. healthcare system."
With the nation already in a nursing shortage, a separate
report released Wednesday by the University of Illinois at Chicago's Nursing
Institute suggests even deeper problems down the road. According to Lynn
Martin, who chaired the university's effort, the coming boom in the over-65
population will find America with not enough healthcare workers "to care
for the people who will need it most."
Between 2010 and 2030, the report noted, the ratio of potential
caregivers to the people most likely to need care will decrease by about