Jul 28

Written by: Besselman and Little
7/28/2011 2:47 PM 

From 1990 to 2009, the number of hospital emergency departments in non-rural areas in the USA declined by 27%, according to a study in today's Journal of the American Medical Association.

"That's a hefty number, and more than I expected," says study author Renee Hsia, an assistant professor of emergency medicine at the University of California-San Francisco.  Hsia and her colleagues found that the number of emergency departments dropped from 2,446 to 1,779 - an average of 89 closings per year.  The figure included only non-rural locations since those in rural areas generally receive special funding from federal sources.

Hsia says researchers wanted to examine the factors that led to closings. "Certain hospitals are at higher risk for losing their ERs than others," she says. ERs shut down were more likely to:
-  Have low profit margins
-  Serve patients below the poverty level
-  Serve patients with poorer forms of insurance, including Medicaid
-  Be in for-profit hospitals
-  Be in more competitive markets

Hsia says it's very concerning that during the same period of time that number of ERs has decreased, there's been a 35% increase in ER visits.  "The ER is the bird's eye perspective of the whole healthcare system.  If we really want a better system, not just band-aid solutions, we need to look at how to simplify the way we pay for health care," says Hsia.

Source:  www.usatoday.com