Studies: Minor complaints not driving ED overcrowding, costs

But a tool used to assess this finding may not be accurate for this purpose, and other system factors could be more important.

By Victoria Stagg Elliott, AMNews staff. June 4, 2007.

Nonurgent problems are not packing emergency departments beyond their capacity, and reducing the use of this medical service will not much affect the amount of money that is spent by public programs such as Medicaid, according to studies presented at the Society for Academic Emergency Medicine annual meeting last month in Chicago.

This research is the latest to challenge the notion that emergency department overcrowding is primarily the result of uninsured patients using these facilities to care for minor health issues that could be dealt with in primary care or other settings.

"It's a myth," said Linda Lawrence, MD, president-elect of the American College of Emergency Physicians. "We do see nonurgent issues because people do not have anywhere else to go, but they do not cause the ED to be crowded. They're straightforward, in-and-out sort of patients."

ED overcrowding is a long-recognized problem. An American Medical Association report issued in November 2006 found the emergency/trauma care system to be at a "crisis point." The organization's policy calls for expansion of the emergency health care system capacity and triage systems that can direct patients to appropriate health services based on symptoms.

Experts suggest that these recent studies, along with previous ones, indicate that the problem is not just a result of what goes on in the emergency department. The entire health care system plays a role, and trouble in this one area is a sign of challenges elsewhere.