Although a slim majority of hospitals affiliated with the VHA national purchasing cooperative report little change in the amount of uncompensated care delivered in their emergency departments, 45% of responding hospitals say they are providing more free emergency care than they did 12 months ago, according to a survey of ED directors.
Only 2% saw a drop in uncompensated ED care.
Emergency volume apparently is on the rise as well, as 43% of the 107 VHA hospitals participating in the survey have plans to expand their EDs in the next year.
"The emergency department is traditionally the hospital door that is always open. Now many hospitals are struggling to keep those doors open," says Jeanne McGrayne, a registered nurse who heads up ED consulting for Irving, Texas-based VHA.
Still, more than 71% of hospitals say patients wait less than an hour, on average, to see a physician from the time they arrive at the emergency room. Nearly as many claim that they have not had to divert ambulances to other hospitals in the past 12 months due to ED overcrowding.
Among the responding hospitals, a shortage of beds for acute and critical care is the No. 1 factor in ED overcrowding and waiting time. The closing of EDs at other hospitals also plays a major role, according to the study.
Despite numerous reports to the contrary, the VHA hospitals surveyed are not experiencing a major shortage of specialists available to care for emergencies, as that rated last among the six causes of ED overcrowding listed in the survey.