Monday, December 17, 2007

Emergency room waiting times

What are waiting times like in your part of the world if you have to visit an emergency room? We hear such horror stories about waits that take hours, but then we hear stories about people who have no wait at all.

Here, in Canada, we have our issues with the socialized medical program, Medicare. The biggest argument I hear from Americans when they don’t want to have socialized medicine, is that we have horrendously long wait times. But, I have many American friends and acquaintances, and I’ve heard about incredibly long wait times for them and their friends as well. Is one system better than the other?

Personally, I’ve been very fortunate for serious issues – elective ones, nuisance ones, could take a while. I remember taking my children to the emergency room for what we perceived as urgent issues. When it was truly urgent, we were taken immediately – if it wasn’t urgent, the wait could be hours, but I do understand why, as frustrating as it can be.

But, I think that a lot of it goes to how the emergency rooms are used – and many times, they aren’t used properly. Is that always the patients’ fault though?

In Canada, it can be very difficult to find a family doctor; with the number of doctors retiring or cutting back on their work hours, the remaining doctors can’t take the full load. Without a family doctor, and if walk-in clinics are closed, many families don’t have a choice but to go to the ER. In the States, if someone isn’t covered with insurance, they may leave their problem unattended to until it becomes so serious that they have to go to an emergency room.

So, this adds to the number of people visiting – but why can it take so long to be seen by a doctor in the ER? There are only so many beds in the hospital. Many of the patients who present to the emergency room have to be admitted, but if all the beds are full, the emergency patients have to wait, taking up an ER bed. If the ER bed is taken, the ER staff can’t see another patient from the waiting room; they’re too busy caring for the patients who are waiting.

The solution may seem obvious, free up the hospital beds. But if you are in an area that has few long-term or chronic care beds, many patients who no longer need acute care but still need some sort of care have nowhere to go. They can’t go home; there’s no-one to care for them. So they stay in the acute care beds and wait.

There’s another issue that bears acknowledging: our nursing shortage in North America. People aren’t going in to nursing at high enough numbers. Nurses aren’t being paid enough and they’re not being treated and respected as the professionals they are. So, if there aren’t enough nurses, beds in the hospitals can’t stay open. Sometimes, whole units or floors are closed because there are no nurses to care for the patients. That means fewer beds for the patients down in emergency.

Health care prevention would play a big role in reducing the number of ER visits, more chronic care beds would help too. And finally, better accessibility to home care, to supporting people to stay at home as long as possible, would all play a role in helping speed up care for those who do need it.

News for today:
At-home sleep apnea tests sanctioned by U.S. sleep authority
New sterilization technique for women to be reviewed by FDA
Men may also carry breast cancer genes: study
Survey underscores importance of emotional/educational needs among women with advanced breast cancer
Survival Shortened When ER/PR Negative Breast Cancer Spreads to the Brain
Drug combination shrinks breast cancer metastases in brain
Health needs higher for kids of abused moms
Breathless babies: Preemies' lung function shows prolonged impairment

1 comment:

Crabby McSlacker said...

It does seem like a tremendous waste of resources to have people using emergency rooms for primary care. It's interesting that you folks have problems with that too--somehow in my mind I always think the Canadians have this stuff all figured out and it's just our dumb system in the U.S. that causes all the problems.