Preventable deaths from overcrowded ERs

Ambulance diversion, the rerouting of emergency vehicles from emergency rooms due to overcrowding, has been tied to an increased risk of patient death. A new study in the Journal of the American Medical Association has found that, when ambulances were diverted from ERs for 12 hours or more, there was a 20 percent increased risk of death among a group of nearly 14,000 elderly heart attack patients.

Dr. Renee Hsia, an emergency physician at the University of California, San Francisco, led what is thus far the largest study of how emergency room overcrowding affects patients. Dr. Hsia and colleagues noted that, even as patient visits to the ER rose by 35 percent over the past two decades, the number of ERs has dropped by more than a quarter. And, as their study suggests, the outcome for patients has been far from positive. Observing that there is a significant number of patients who use ERs as their source of primary care, ACSH's Dr. Gilbert Ross thinks that the kind of overcrowding that results in ambulance diversion might be reduced if there were a means of dissuading people from visiting the ER with non-emergency medical needs. If we could winnow down the number of patients who go to the ER for routine matters, we could eliminate much of this problem, he says.

ACSH s Dr. Josh Bloom adds, If this is the future of health care in this country, we should all be afraid. It is totally unacceptable for people to die in ambulances while they are being transported a greater distance because there are too few ERs.