The study finds that in the past decade (1990-1999) emergency departments in California decreased by 12 percent, while the number of emergency department visits at each hospital increased 27 percent to about 25,778 annually.
When selected emergency departments permanently closed, the remaining emergency departments added beds. According to the study, the number of emergency department beds per population increased from 14.5 beds to 15.3 beds per 100,000 population.
Our study shows that while emergency departments have added beds, the typical emergency department patient is much sicker than a decade ago, said Susan Lambe, MD, of the University of California at San Francisco, and the studys lead author.
The study finds over the past decade the number of critically ill visits at each emergency department increased by 59 percent and urgent visits for each emergency department increased by 36 percent. While in 1990 nonurgent patients were the largest group of California emergency department visits, in 1999 urgent patients accounted for the largest group of visits, added Dr. Lambe.
For years, insurance companies, HMOs and some health policy advisors have said that emergency departments attract and encourage patients with nonurgent problems, said Robert W. Derlet, MD, of the University of California Davis Medical Center in Sacramento, and author of a related editorial in this issue. This study clearly indicates a dramatic increase in patients who need emergency care, which leaves little capacity in the emergency department to care for people with less urgent problems.