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GAO FINDS UNCOMPENSATED COSTS, INCREASING CASELOADS COMMON IN NATION'S EMERGENCY DEPARTMENTS

 Emergency Physicians Cite Need for Health Care Reforms
 WASHINGTON, Jan. 15 /PRNewswire/ -- "Hospitals and physicians are suffering undue stress from the increasing use of emergency rooms," U.S. Sen. Donald Riegle (D-Mich.) said, citing findings of a General Accounting Office report he released at a press conference in Washington.
 The report, "Emergency Departments: Unevenly Affected by Growth and Change in Patient Use," is the first nationwide study on emergency department overcrowding and the impact of the growing use of the emergency department by the uninsured, Medicaid patients, and others without adequate health care coverage. This report is also the first to present comprehensive data on the impact of these factors relative to hospital size and community setting.
 "Both hospitals and emergency physicians are facing a crisis because they are being asked to provide more care in the ED with dwindling resources," said Robert M. Williams, MD, FACEP, president of the American College of Emergency Physicians (ACEP). "This report clearly shows that emergency department overcrowding is the result of a failing health care system that is not meeting the basic medical needs of enough people."
 The GAO's findings included:
 -- ED visits increased 19 percent between 1985 and 1990. This growth was most often attributed to the number of people without health insurance, the increase in more serious illnesses, and the elderly's growing use of emergency services. Large hospitals and those in urban areas also reported increases due to illnesses and injuries related to alcohol, illegal drugs, violence and AIDS.
 -- Growth in ED visits nationwide was highest for Medicaid and Medicare patients, followed by the uninsured. According to the GAO, if ED use by Medicaid patients and the uninsured continues to increase at a faster rate than use by the commercially insured, hospitals could face a greater burden of uncompensated care and a diminished ability to offset their losses.
 -- In 1990, 42 percent of ED visits were for non-urgent conditions. The most frequent reason given for non-urgent use of the ED was the patients did not have a primary care physician. Rural and small hospitals were more likely to report high proportions of non-urgent visits.
 Arthur L. Kellermann, M.D., M.P.H., FACEP, director of the emergency department at the Regional Medical Center in Memphis, Tenn., and a prominent expert on the problem of hospital and emergency department overcrowding, joined Williams in calling for universal access to primary care as a means to alleviate some of the pressures facing emergency departments.
 "Most patients with non-urgent conditions come to us because they are in pain or discomfort and they can't readily get care anywhere else. Others put off coming in as long as they can, and when we finally see them their illness has progressed to the point that it is far more difficult -- and far more costly -- to treat," Kellermann said.
 Williams called for three health care reforms that would alleviate some of the factors contributing to emergency department overcrowding:
 -- A basic level of health insurance for all citizens, including enhancing publicly sponsored health insurance so that primary care physicians would treat patients with public insurance.
 -- Health care prevention programs, including injury prevention, immunizations, prenatal care and incentives to encourage patients to seek primary care.
 -- Increased services such as home health care and long-term care, which help keep patients out of the ED by providing alternative levels of care.
 "The American public has always known that they can count on their hospital emergency department," said Kellermann. "Emergency physicians, nurses, and EMS personnel staff these departments 24 hours a day, seven days a week. Hospital emergency departments cannot continue to cover for the deficiencies in our costly and increasingly inadequate system of care without compromising our primary mission -- to provide high quality, life-saving care to anyone who needs it."
 The American College of Emergency Physicians is a national medical specialty society representing more than 16,000 physicians who specialize in emergency medicine. The college is dedicated to improving emergency care through continuing education, research, and public education. Headquarted in Dallas, ACEP has 53 chapters representing each state, as well as the District of Columbia, Puerto Rico, and government services.
 -0- 1/15/92
 /CONTACT: Kate Perrin or Jane Howell of American College of Emergency Physicians, 202-728-0610/


CO: American College of Emergency Physicians ST: District of Columbia IN: HEA SU:

TW -- DC025 -- 5558 01/15/93 17:13 EST
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Date:Jan 15, 1993
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