Hospital emergency departments continue to face over-crowding, according to a new study by the General Accountability Office (GAO).
In the June 1 study, the GAO found hospitals continue to divert ambulances, with about one-fourth of hospitals reporting going on diversion at least once in 2006.
The study also found that wait times in the emergency departments increased, and in some cases exceeded recommended time frames. For example, the average wait time to see a physician for emergency patients - those patients who should be seen in 1 to 14 minutes - was 37 minutes in 2006, more than twice as long as recommended for their level of urgency.
Boarding of patients in the emergency department who are awaiting transfer to an inpatient bed or another facility continues to be reported as a problem. the GAO found.
For the study, the GAO examined information made available since 2003 on emergency department crowding. GAO examined three indicators of emergency department crowding - ambulance diversion, wait times, and patient boarding - and factors that contribute to crowding. The GAO reviewed national data; conducted a literature review of 197 articles; and interviewed officials from HHS and professional and research organizations, and individual subject-matter experts.
Hospital emergency departments are a major part of the nation's healthcare safety net. Of the estimated 119 million visits to U.S. emergency departments in 2006, over 40 percent were paid for by federally-supported programs. These programs - Medicare, Medicaid, and the State Children's Health Insurance Program - are administered by the Department of Health and Human Services.
There have been other reports of crowded conditions in emergency departments, often associated with adverse effects on patient quality of care. In 2003, the GAO reported that most emergency departments in metropolitan areas experienced some degree of crowding.
Lawmakers are concerned that the high cost of healthcare is forcing an increasing number of uninsured to use emergency departments for their primary care.
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