Crowded emergency rooms are having a serious ripple effect on care in Los Angeles, and anecdotal evidence suggests the problem is widespread, according to a new study to be published next month in the Annals of Emergency Medicine. The study, in the peer-reviewed journal of the American College of Emergency Physicians, said the delays are forcing ambulances by the dozens to sit idle outside hospitals while paramedics wait to transfer patients to an increasingly scarce supply of beds. From April 2001 to March 2002, researchers identified 21,240 incidents when Los Angeles Fire Department ambulances were out of service while paramedics waited to transfer their patients -- or one of every eight transports. "Emergency patients who need to be hospitalized are boarded in emergency departments until inpatient beds become available. This causes the whole system to back up and reduces the ability of emergency medical staff to care for more patients coming by ambulance," said Marc Eckstein, lead author of the study who is an emergency physician with the Keck School of Medicine of the University of Southern California at Los Angeles and medical director of the Los Angeles Fire Department. The median delay was 27 minutes, although the wait rose to one hour or more in 8.4% of those cases, the study said, placing much of the blame on a lack of beds at many hospitals, particularly in the intensive-care units. The study said emergency visits have increased by 59% over the past decade across California at the same time that the number of critical-care beds in the state has dropped 4%. Meanwhile, the number of emergency departments in California decreased by 12%, according to the study. -- by Michael Romano
ER crowds, lack of beds delay ambulances: report
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