Emergency department crowding continues to be a significant problem for the nations hospitals, according to new data on ambulance diversion, wait times and patient boarding in a report from the Government Accountability Office. Of the estimated 119 million visits to U.S. emergency departments in 2006, more than 40% were paid for by federally supported programs, including Medicare, Medicaid and the State Childrens Health Insurance Program, the report said. Also in 2006, about one-fourth of hospitals reported diverting ambulances at least once, while the average wait time for emergent patientsthat is, those who should be seen in one to 14 minuteswas 37 minutes that year.
Available information suggests that a lack of access to inpatient beds is the main factor contributing to emergency department crowding, the GAO said in its 58-page report. Additionally, other factorsa lack of access to primary care, a shortage of available on-call specialists, and difficulties transferring, admitting, or discharging psychiatric patientshave also been reported as contributing to crowding.
Finally, the GAO said some of the articles that it reviewed discussed strategies to address crowding, but that those strategies have not been assessed at either the state or national level.