Results Signal Warning To Nation about Enacting National Reforms

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Boston, MA — Nearly two-thirds of emergency physicians in Massachusetts report more patients are seeking emergency care as result of state health care reforms, and nearly two-thirds of Massachusetts residents say emergency department wait times for them have increased or remained the same, according to two polls released today by the American College of Emergency Physicians (ACEP) during its annual meeting in Boston. 

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"This is clear evidence of what emergency physicians across the country have been warning — that universal health coverage alone will not solve the problems facing emergency patients," said Dr. Angela Gardner, president of ACEP.  "We support universal coverage, but national health care reform must address the severe problems facing the nation’s emergency patients, such as dangerous delays in care.  For example, it’s unacceptable that emergency patients who need to be seen in 1 to 14 minutes are being seen in twice that timeframe [GAO 2009]."

A study commissioned by ACEP and conducted by Harris Interactive showed nearly half of the respondents (47 percent) had been to an emergency department in the past year (either for themselves or with a family member).  While 90 percent of Massachusetts residents with health insurance report being satisfied with their health insurance coverage, more than seven in 10 (72 percent) say their frequency of ER visits has remained the same (68 percent) or increased (4 percent).  Eighty-four percent say ER care should be a priority for health care reforms at the national level.

"A large percentage [84 percent] of residents are saying emergency care should be a priority for national health care reform," said Dr. Peter Smulowitz, an emergency physician and core faculty at Beth Israel Deaconess Medical Center and Harvard Medical School.  "Most also are reporting their waiting times in the emergency department are longer or no different from previous visits made prior to 2006."

In a poll of emergency physicians in Massachusetts, conducted by ACEP, more than half of respondents (51.1 percent) report patient acuity levels have remained the same since the Massachusetts mandate.  More than 20 percent report higher acuity levels, and more than 27 percent report lower acuity levels.

"The idea that emergency departments are being filled with people who don’t need to be there is simply not true, and these polls confirm that," said Dr. Gardner.  "People will always need emergency care.  The medical realities of a growing elderly population also tell us that.  Emergency rooms are an essential community service that need support now." 

"Universal coverage is a key step in health care reform, but we need to correct the misperception that it will solve the problems in emergency departments," said Dr. Smulowitz.  "More than 62 percent of emergency physicians said that "boarding" — or holding — admitted patients in emergency departments has increased or stayed the same since the Massachusetts mandate.  And boarding is the primary cause of overcrowding."

"Every person in America must have affordable health insurance coverage, and quality of care must improve," said Dr. Gardner. "Eliminating the billions of dollars spent annually in defensive medicine and administrative overhead would greatly reduce costs, and we know that moving emergency patients to their inpatients beds after the decision is made to admit them to the hospital goes a long way to improving throughput through emergency departments."

ACEP supports the measures below to reform the nation’s health care system:

• Every person in America must have meaningful and affordable health insurance coverage provided through a combination of employer and individually mandated insurance. It should be means-tested, allowing those in need to receive coverage or financial support to buy insurance. A combination of private sector and governmental solutions may be needed to achieve universal coverage. America is experiencing a dramatically rising tide of uninsured and underinsured patients. Emergency physicians are the only doctors in the country required by federal law to treat all patients regardless of their ability to pay. It is a responsibility we embrace proudly, but many emergency departments and physician groups are closing under the burden of uncompensated care.
  
  
• Health care costs must be reduced. Significant medical liability reform is needed to eliminate unnecessary, expensive tests known as "defensive medicine." Liability reform can also help increase the availability of critically needed on-call specialists. Widespread adoption of electronic health records could substantially cut costs and improve patient care if there were complete integration of data between the emergency department and other medical settings. Administrative and overhead costs must be reduced.
  
  
• Quality and patient safety must be improved by eliminating the practice of "boarding" admitted patients in emergency department hallways until they are transferred to an in-patient hospital bed. This can be achieved by establishing quality standards that define how quickly admitted patients are moved to their appropriate care settings, with such information reported and available to the public.
  
  
• A national surge capacity plan must be developed and resources provided to prepare our nation's hospital emergency departments for public health crises such as the H1N1 pandemic, a terrorist attack or other catastrophes.

This Massachusetts health care study was conducted by telephone within Massachusetts by Harris Interactive on behalf of the American College of Emergency Physicians between September 9, 2009 to September 16, 2009, among 1,002 adults ages 18 and over who live in Massachusetts, 977 of whom have health insurance — of which 665 have private health insurance and 108 have the Commonwealth Plan.  A full methodology is available.  For full survey results, please contact Mike Baldyga at 800-320-0610, ext 3008.

 The emergency physician poll was conducted by the American College of Emergency Physicians from September 17 to September 21, 2009.  E-mails were sent to 755 emergency physicians in Massachusetts, and 138 responded.

ACEP is a national medical specialty society representing emergency medicine.  ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. 

Harris Interactive is a global leader in custom market research.  With a long and rich history in multimodal research that is powered by our science and technology, we assist clients in achieving business results.  Harris Interactive serves clients globally through our North American, European and Asian offices and a network of independent market research firms.  For more information, please visit www.harrisinteractive.com

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