Study: EDs Closing at Significant Rates

The default line of thinking with respect to care access in this country pre-reform was that — whatever the patient outcome — there was “always the ER”. Doesn’t take a rocket scientist to realize that this maxim was emblematic of the proverbial “broken healthcare system”.

The default line of thinking with respect to care access in this country pre-reform was that — whatever the patient outcome — there was “always the ER”. Doesn’t take a rocket scientist to realize that this maxim was emblematic of the proverbial “broken healthcare system”. Seen as part municipal safety-net, healthcare economic loss-leader, and all around (fragmented) primary care clinic, the venerable acute hospital emergency department as an icon of healthcare delivery was, indeed, the jack of all trades and the master of none — at least as far as coordinated, cost-effective, valued delivery was concerned. The healthcare marketplace should be saturated, right? Well, according to a recent report, their availability is shrinking.

Urban and suburban areas have lost a quarter of their hospital emergency departments over the last 20 years, according to the study, in The Journal of the American Medical Association. In 1990, there were 2,446 hospitals with emergency departments in nonrural areas. That number dropped to 1,779 in 2009, even as the total number of emergency room visits nationwide increased by roughly 35 percent.

The study highlights another important aspect to consider in the supply side of things in healthcare policy: EDs really aren’t sucking the healthcare system dry (less than 5 percent of total healthcare costs, taken by itself), and in hypercompetitive healthcare marketplaces, those EDs have to fight to survive. | LINK

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