As healthcare workers face historically high burnout rates, the impact of America’s struggling hospital system is trickling down to the waiting rooms.
Patients across the country are facing exceptionally long wait times in emergency departments (EDs) – with patients in some states waiting more than four hours for treatment.
The average length of time for patients from the time they first present to the emergency department to the time they are sent home from the hospital varies widely from country to country.
In areas with fast wards you can be seen within an hour and forty minutes, while in areas with more delays it is more than four hours.
In addition to the annoyance, long waiting times can cause life-threatening complications, endangering the health of patients.
The average national time spent in A&E before being discharged is two hours and 45 minutes.
But almost half of US states exceed this, with Maryland having the longest hospital wait times: 247 minutes, just over four hours.
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Massachusetts and Rhode Island are tied for second place at 214 minutes.
Delaware (211 minutes), New York (202 minutes) and New Jersey (194 minutes) round out the top five, according to data from the Centers for Medicare and Medicaid Services analyzed by legal finance firm High Rise Financial.
Spending more time in the emergency department increases the risk of complications such as infections and increases the risk of patients leaving before receiving treatment.
The bottom five states, where patients can be expected to get to the emergency room in two hours or less, are North Dakota (107 minutes), Nebraska (114 minutes), South Dakota (115 minutes), Oklahoma and Iowa (117 minutes). ) and Hawaii (120 minutes).
Long waiting times in emergency rooms have plagued hospitals for years. A study conducted more than a decade ago found that longer durations were associated with an increased risk of hospitalization or death within seven days.
Although the overall risk is low, the risk of hospitalization has increased by up to 95 percent, while the risk of death among the sickest patients has increased by up to 79 percent.
A separate 2018 study found that longer emergency room wait times are linked to more deaths and decreased patient satisfaction.
Dr. LouAnn Giangreco, a board-certified emergency physician and chief medical officer of American Family Care, a network of urgent care clinics, told DailyMail.com that emergency wait times are often a sign of an area’s overall health ecosystem.
She said the length of stay in an emergency room “really depends on the entire health ecosystem that is around the emergency department,” including resources in the community and access — in the absence thereof — to preventive care services.
If the area does not have reliable or quality daily health care, it “turns the emergency department into a safety net” for all conditions – including non-emergencies.
As burnout among healthcare providers skyrocketed during the Covid pandemic, hospitals felt the impact of staffing and supply shortages.
Dr. Giangreco said, “The other end is what’s happening within the hospital system.
“If that hospital system has a limit on the number of beds they have, it prevents individuals from being able to go to the hospital to get care.”
“So they’re kept in the emergency department for care when they really need to be on the hospital floor.”
In addition to the lack of routine care, Dr. Giangreco said mental health in emergency rooms is becoming an increasingly common problem.
Part of the catch-all nature of the emergency department is that people come in with behavioral health issues and have limited access to care in the community, leading to overcrowding of waiting rooms.
To address the problem and improve care, Dr. Giangreco emphasized the importance of access to routine preventive care, which would preserve a person’s health and reduce the chance of a complication requiring an emergency room visit.
Increasing telehealth and urgent care services can also provide faster and more accessible “interim” health care.
Supporting physicians, nurses, and Advanced Practice Practitioners (APPs) so they don’t burn out and leave hospital systems is critical to reducing emergency room wait times and improving patient care.
Maryland leads the nation in the longest emergency room wait times and is a state that is no stranger to the top charts when it comes to hospitals or health care, according to previous reports from DailyMail.com.
Dangerous medical blunders resulting in death or serious injury have more than tripled in hospitals across the state between 2019 and 2022.
A state report found that there were 832 adverse events between October 1, 2021 and September 30, 2022, which was also the highest since records began in 2004.
Of the incidents, 769 were classified as the most serious, or level 1, events, defined as adverse events leading to death or serious disability.
In one case, a patient had surgery on one of his legs and ultimately had his other leg amputated due to a serious medical complication.
In another case in 2021, three people died after a maintenance worker accidentally shut off an unlabeled oxygen line.
Another blunder was that a premature baby with a low birth weight was given the wrong dose of steroids for almost two weeks.
Total events in 2022 were a 52 percent increase over 2021, and the highest the state has ever recorded since it started collecting data in 2004.
The report, which attributed the increase in adverse events in part to easing staffing and supply shortages during the Covid-19 pandemic, included results from 62 hospitals in the state of Maryland but did not identify which hospitals the events occurred in.
The Leapfrog Group, a private organization that evaluates hospital safety metrics, ranked Maryland 35th for patient safety, giving only nine hospitals in the state the highest Level A safety rating.
Total events in 2022 were a 52 percent increase over 2021, and the highest the state has ever recorded since it started collecting data in 2004.
The report, which attributed the increase in adverse events in part to easing staffing and supply shortages during the Covid-19 pandemic, included results from 62 hospitals in the state of Maryland but did not identify which hospitals the events occurred in.
The Leapfrog Group, a private organization that evaluates hospital safety metrics, ranked Maryland 35th for patient safety.
The agency gives only nine hospitals in the state the highest Level A safety rating.
Based on the findings, the report’s authors emphasized that hospitals must prioritize safety and optimize processes to avoid system failures that could lead to serious errors.
Also leading Maryland in rates of Alzheimer’s disease.
The state of Maryland ranks first for the highest rate of Alzheimer’s disease in the United States, despite doing better in obesity, household income and residents with health insurance.
The traditionally Democratic state, located next to the nation’s capital, has more than one in eight people aged 65 and over with the condition, compared with about one in 10 nationally.
Maryland is also the only state with two counties with the top 10 highest Alzheimer’s rates.
Baltimore City tied for first with 16.6 percent of people over 65 and Prince George’s County was fourth with 16.1 percent.
Dr. Kumar Rajan, author of the first-ever report on Alzheimer’s disease rates at the county level, published last year in The Journal of the Alzheimer’s Association, said the disease’s prevalence in Maryland is due to a higher number of black and Hispanic residents.
These minority groups may have higher rates of dementia, health experts say, because they are more likely to suffer from heart disease, diabetes and high blood pressure – all conditions that affect brain health.
Previous research has found that older black Americans are twice as likely to develop Alzheimer’s disease or other forms of dementia than older whites, and that older Hispanics are about 1.5 times more likely to develop the disease than their white counterparts, due to confounding factors such as comorbidity and social aspects, such as racism. and discrimination.
In addition to the coexisting medical conditions, the Alzheimer’s Association said the higher prevalence of Alzheimer’s disease among blacks and Hispanics can likely be explained by health and social disparities, as well as the marginalization and discrimination of these groups in the United States, which is deeply rooted in history.
Dr. Keith Vossel, Alzheimer’s disease program director at the department of neurology at the University of California, Los Angeles, previously told DailyMail.com that marginalized groups experience stress, violence, discrimination and racism. All of these life experiences can influence epigenetic changes, which change the way a gene is expressed.
Although Dr. Giangreco couldn’t definitively say why Maryland is experiencing the highest wait times, she said it’s important to examine a hospital’s staffing levels, quality measures and errors to determine the root cause — and address them.