Declining ED Patient Volumes
Posted by WhiteCoat on November 22, 2008
It appears that the poor economy is having an effect on the number of ED visits all over the nation this year. The local census in hospitals in our area is off about 7% from last year. Most hospitals are reporting a drop in patient volumes. Is your hospital seeing a drop in ED patient volumes also?
Anyway, there was an email sent around on a SAEM listserv asking for statistics regarding the increase or decrease in number of ED patient visits this year.
One response from Arizona was particularly thought-provoking.
In the Maricopa Medical Center in Arizona, the director of the ED commented that 45% of adults and 80% of children seeking ED care at the hospital emergency department are Hispanic. The economy in the area is getting worse and the hospital believes that many of the patients that usually come to the ED have left town. The census in their hospital was reportedly down up to 6% from the same period last year.
Oh, the ED director did note one other thing that might be contributing to the decrease in ED visits. He sent a picture of the sheriff’s van that is often parked directly outside the ED entrance.
William said
Things that make you go “Hmmmmmmm”.
William sends.
Tex said
Around NC, the poor economy has illegals leaving in droves…no work.
Our ED volumes are down. Most ED patients are those without insurance (lay-offs), so the family doctors won’t see them. Hospital census is down by my estimated guess, 10%. We have 3 ICUs, one is completely closed, the other two at about 60%. Hours being cut throughout. Looks like it’s gonna be a bad Christmas.
ERnursey said
Heh Heh Heh, that’s a good one.
Pharmacy Psychic said
I spent the summer in Phoenix and I’m pretty sure there are multiple vans like this. They hang out in various places which are likely to be visited by illegal immigrants.
keepbreathing said
We’ve seen a lot less business than usual for this time of year in the ED. There are up days and down days, but on the whole it’s been unusually quiet in the halls of madness.
Declining ED Patient Volumes « WhiteCoat Rants said
[...] Original post by unknown [...]
ernurse said
We are definitely seeing a drop in visits in my ED too, which we all find odd considering that the cold weather season is peak time for us. But with the economy I guess it makes sense. I hadn’t thought of the fact that people, especially the Hispanic workers who make the vast majority of our patient population, may be leaving town seeking greener pastures elsewhere.
Stiff Man said
Just a view from the other side of the curtain here. No complaining, just thought this was kinda “funny”.
My 11 y.o. has had a sore throat for the last three days. We kept him home from school the first day because of the sore throat and he looked ashen, so we thought we would let him go back to bed to sleep and we would re-evaluate him for school the next morning. Repeat same the next morning.
After 3 days out of school our system requires us to have a doctor’s note or he is not allowed back in until obtaining the note. We now, after moving into this county two months ago, live in a pretty rural county. I didn’t realize how rural until we tried to locate a “doc-in-the-box” (DITB) clinic in the area to have son treated for strep or whatever was afflicting him as well as get the above note for school. We have not yet found a family doctor in this area. I quickly found out after making some phone calls to the local hospital and talking to my next door neighbor that there aren’t any quick clinics, and the calls to the local family practice docs resulted in us not being able to be seen as a new patient because they are full due to “the flu” going around the schools, affecting the kids and their parents at home.
The advice from the hospital and the docs’ offices? Take him to the ED to be seen.
Shaking my head and telling my wife what I had learned on the phone, we decided to go to the next county north of us which has a few DITBs. I ended up paying a $20.00 copay for son to be seen instead of a what? $600.00 for him to be seen in the local ED.
I realize that the local ED would have loved for us to pay them a visit because we have private insurance but there was no way that I could justify financially going to the ED instead of a DITB. After reading here and several other MedBlogs that I follow I could not see taking son to the ED for a non-emergency complaint. I do not know if other people in this community do go to the ED for non-emergent complaints or if they have family practice docs that normally take care of them. I guess that was the easiest idea for the person answering the telephone at the hospital to give me, to go to the ED, as well as “soliciting” business for the hospital, but I just couldn’t do it.
I am not looking for a pat on the back for doing what I did. To be honest, I could hear the sound of NurseK’s “blog voice” screaming in my ear that that would have been a drain on the resources of the hospital and tied up staff that should be dealing with true emergencies, even though this community suffers very few emergencies due to gunshots, MVA’s and the like. Mostly old farmers complaining of chest pain after working the fields all day.
Cheers
I don’t think that most medical providers are going to give you a hard time for going to the ED for a sore throat. Happens to everyone once in a while. I’m sure that if you described what happened above and were nice about it, you might get bumped up in line. In fact, the minor injuries are the “bread and butter” of emergency care. If all we took care of was major medical emergencies, we’d be doing nothing a lot of the time.
The things that will drive most ED staff bonkers is the people who demand to be seen first because they were there “before the guy with the heart attack,” the people that seek emergency care for a problem that has been around for 3 months, and the people that show up in the ED every week with runny noses and coughs.
Angela said
So those vans scare people off and they go untreated, spreading infection to other school children and co-workers creating a wider public health burden than if they were just treated in the first place.
Sallie said
They are here, in Sunny SE Texas, land of Hurricane IKE, abundant construction jobs and close proximity to the border. Our hospital alone has many workers here for the clean-up and the license plates on the vehicles they are diving are from LA, FL, AL, GA etc.
Pink said
What kind of “health burden and infection” are you alluding to, Angela?
Is the recession affecting ED volume? « The ACUTE CARE Blog: Non-Urban Emergency Medicine said
[...] sees a decline, and notes that in border like Arizona, Hispanics that normally visit the emergency department have [...]
Rae said
They’re all here at my hospital…
Every day here is the same – 25 people being held in the ER waiting for beds, the PA system constantly chiming in (hospital-wide) “code yellow – hospital at capacity – continue hallway protocol” – which means that we have beds/patients in the middle of the hallways on any given floor. We have 5 ICU units here – Med-surg ICU x25 beds, Trauma ICU x25 beds, Neuro ICU x25 beds, CICU x25 beds, and CVICU x25 beds…all are full, all the time. Our ER capacity is x80 beds…all full, all the time.
Come down here and work with us. We won’t cut your hours!
Suzanne said
Call me ignorant, but when I saw “ED” I was thinking “Erectile Dysfunction.” The post made perfect sense until it started talking about 80% of children seeking ED care… Then I knew something wasn’t right.
That’s funny.
ED versus ER is a pet peeve of mine.
Meghan said
I don’t know statistics, but I do know that we’ve been as crazy busy as usual, and we admitted a ton of patients this week.
ER nurse in So Cal
Platy said
That van looks like it’s kind of close to EMTALA Violation territory.
Meanwhile, our ED is on track to break 100,000 visits in 2008 (we usually end up in the low 90,000’s).