Report Finds Spate of Emergency Room Closings in Poor Areas

Emergency rooms in the United States have closed at an alarming rate over the past 20 years, particularly those serving lots of poor patients, says a new report in the Journal of the American Medical Association.

From 1990 to 2009, the number of hospitals with emergency rooms in urban and suburban areas declined from 2,446 to 1,779, a 27 percent drop, the research found. 

Dr. Renee Hsia, lead author of the study, told Bloomberg that the closures are hurting patient care and causing overcrowding in the remaining emergency rooms.

“When people don’t have ERs in their neighborhood, it’s not like their emergency disappears,” said Hsia, an assistant professor of emergency medicine at the University of California, San Francisco, and an emergency room doctor at San Franciso General Hospital.”The emergency departments can’t pay for themselves, and it’s expensive care.”

Federal law requires emergency rooms to treat patients regardless of their ability to pay, the study noted. That leaves them vulnerable to the harsh economics that have prompted hospitals, particularly struggling for-profit facilities, to close ERs.

“We can’t expect  the market to allocate critical resources like these in an equitable way,” Hsia told The New York Times.

Dr. Sandra Schneider, president of the American College of Emergency Physicians, added that financial pressures have left “emergency care in this country in crisis …. We don’t anticipate it will get any better.”

A hospital trade group official criticized the JAMA study. Steve Speil, senior vice president with the Federation of American Hospitals, said the researchers’ data-collection methods may have exaggerated the number of emergency rooms that have closed because of the way they accounted for hospital mergers. Even so, he acknowledged that  emergency room overcrowding is “a major problem.”




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