Last week, the Los Angeles Times reported that the already busy emergency room at Los Angeles County-USC Medical Center -- one of the biggest public hospitals in the country -- is getting even more crowded. This week, a report in the Journal of the American Medical Assn. shows that County-USC is hardly alone in experiencing more demand from patients.
Among the findings:
- The number of patient visits in emergency rooms nationwide rose from about 95 million in 1997 to 117 million in 2007 -- an increase of 23%.
- Only about half of that increase can be attributed to population growth.
- The average wait time in ERs rose from 22 minutes to 33 minutes over that period.
- Meanwhile, as demand was growing, the number of ERs dropped 5% from 4,114 in 1997 to 3,925 in 2007.
- In 1997, about 43% of emergency rooms were considered "safety net" ERs (because roughly one-third or more of their patients were on Medicaid or uninsured). By 2007, the proportion had risen to 63%.
The researchers found that most of the increased demand for emergency room services came from adults covered by Medicaid, the government insurance program for the poor. In 1999, there were 693.9 ER visits per 1,000 Medicaid enrollees; by 2007, that number had ballooned to 947.2 visits per 1,000 enrollees. In part, that's because 4.8 million adults were added to the Medicaid rolls during that time -- an increase of 35%.