Study: ER Patients Wait Too Long for Care
Many Hospitals Aren't Meeting Their Own Goals for Limiting Wait Times in Emergency Rooms
Oct. 2, 2009 -- Even the sickest patients treated in hospital emergency
departments across the U.S. routinely wait longer than they should for medical
care, new research suggests.
Just 14% of hospitals met their own target time frame for treating very sick
patients at least 90% of the time.
And slightly less than one in three hospitals met target treatment time
goals 90% or more of the time for all patients treated in emergency
"In hospitals across the country patients are waiting longer than they
should for treatment in ERs," study researcher Leora I. Horwitz, MD, MPH, tells
WebMD. "There is also tremendous variation from hospital to hospital, which has
more to do with how the facilities choose to practice than the characteristics
of the patients they treat."
Triage Targets Not Met
The vast majority of hospital emergency departments across the country now
have triage nurses or doctors who assess patients as soon as they arrive and
determine target treatment times based on how sick the patients are.
In an effort to examine whether individual hospitals were meeting these
triage goals, Horwitz and colleagues from Connecticut's Yale-New Haven Hospital
examined data provided annually to the CDC by medical centers across the
Their random sample included information on 35,849 patient visits to 364
emergency departments in 2006.
The analysis revealed that:
- When patients were found to be in need of hospitalization, less than half
(47.7%) of emergency departments admitted 90% or more within six hours of first
- Less than a quarter (24.5%) admitted hospitalized patients within four
- One in three patients triaged for treatment within an hour waited longer to
see a treating physician.
- The average wait time at the slowest 25% of emergency departments was twice
as long as average wait times at the 25% of the fastest hospitals.
The study was published online today in the Annals of Emergency
Misuse of Emergency Departments
While there is little disagreement that ER wait times are too long,
emergency physician Sandra Schneider, MD, says there is a lot of confusion
among the public about the reason for this.
Schneider is vice president of the American College of Emergency Physicians
and she practices emergency medicine at Strong Memorial Hospital in Rochester,
"When people come to emergency departments [EDs] and have to wait, they
assume this is unusual and that people coming to the EDs for primary care are
to blame," she tells WebMD. "What they don't realize is that EDs are crowded
24/7 and it has little to do with people using them for primary care."
One problem, she says, is that emergency departments have become dumping
grounds for patients waiting to be admitted to the hospital and even those who
have already been admitted.