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Long wait times for ER patients in Md.

The Baltimore Sun

Patients treated in Maryland emergency rooms have among the longest waiting and treatment times in the U.S., according to a national survey.

An Indiana marketing firm surveyed 1.5 million patients treated at 1,500 emergency rooms in 2006 and found that Maryland ranked 45th, with patients spending an average 277 minutes waiting and being treated.

The national average was 240 minutes, 18 minutes longer than last year, according to Matt Mulherin, a spokesman for Press Ganey Associates, the South Bend firm that conducts the annual survey.

"It's total time spent in the ER, not just the time someone waits to be seen," he said.

Maryland fared badly because many of its hospitals serve urban populations with a high percentage of patients who use emergency rooms rather than primary care physicians, said Nancy Fiedler, a spokeswoman for the Maryland Hospital Association. They are also using them more often, she said.

"Waiting even an hour is too long, but part of the problem is hospitals are trying to respond with huge numbers of patients coming in," she said. "Hospitals are making every effort to move patients through more quickly."

For many patients, especially the poor and uninsured, emergency rooms provide the only access to doctors, and they show up for treatment of ailments ranging from colds to chest pains and broken bones, according to Fiedler and other experts.

Mulherin agreed.

"States that have larger metropolitan areas tend to be lower ranked in terms of time spent in the ER; I think that's definitely a valid point," Mulherin said.

South Dakota ranked first in the survey, with patients reporting an average of 158 minutes in the emergency room. Utah ranked 50th, at 381 minutes. California and New York, both with large urban centers, ranked 42nd and 44th, respectively.

The report, known as the "2007 Emergency Department Pulse Report: Patient Perspectives on American Health Care," is designed to help hospitals improve service, Mulherin said.

Randomly selected patients completed a two-page questionnaire that arrived in the mail a few days after they were treated, he said.

Patients also were more pleased with their emergency room treatment if they were seen between 7 a.m. and 3 p.m., he said.

Experts say waiting and treatment times also may be increasing because hospitals are seeing more patients, both nationally and in Maryland.

The number of average daily emergency room visits increased statewide from 4,000 in 1990 to about 6,200 in 2006, Fiedler said.

"There's no question there's been an upsurge in the use of emergency departments, but in Maryland it's particularly profound," she said.

The Baltimore City Health Department, in a report last spring, found that patient visits to city emergency rooms increased from 552,000 in 2002 to 611,000 in 2005, an 11 percent increase.

As emergency departments fill up, hospitals are increasingly posting "yellow alerts," which means they will take only the most serious ambulance patients.

The total number of yellow alert hours logged by hospitals statewide has continued to jump in recent years, increasing from 9,028 hours in 1996 to 38,735 hours last year, according to the Maryland Institute for Emergency Medical Services.

The Maryland Health Care Commission also found in a report released in December that emergency room visits have increased statewide -- and that more than a third of the visits were for conditions that could be treated elsewhere.

The commission's report, prepared at the request of state legislators, found there were 2.3 million emergency room visits in the 12-month period ending June 30, 2006, a 23 percent increase over the same period in 2000.

Of those visits, 18 percent were for conditions that weren't emergencies, and 17 percent required rapid treatment but could have been treated in a doctor's offices, the report said.

The commission recommended studying alternative treatment methods, including urgent care centers.

For a full copy of the emergency room report, visit pressganey .com.

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