Emergency Room Services

Emergency rooms in the USA are under increasing pressure to provide emergency care to all, even if they are non life threatening. This trend in approaching ER for every singly problem is costing the healthcare system a large amount of costs, with the result that the number of ER services and hospitals are decreasing with increased pressure on the remaining healthcare facilities.

Other contributing factors are not helping either. In addition to this the issue of increased alcohol consumption and ER admissions is also beginning to negatively affect the quality of healthcare. Nurses are under more pressure than ever to handle ER efficiently, which is showing no signs of decreasing the number of unnecessary ER admissions.

Alcohol and Drug Abuse Are Main Abusers of Emergency Room Services
Many reports now confirm that Emergency room services are among the most misused healthcare services employed by the patients. Of the many problems with which the patients come into the ER with, the most common are due to alcohol and drug abuse.
According to McGeary (2000) “chronic illicit drug use is a positive as well as a significant determinant of the probability of utilizing the ER.” (McGeary et al, 2000) Substance abusers were 30 percent more likely to utilize the ER services than any other emergencies. (McGeary et al, 2000)
The above statements and study results point out to many issues and findings. Firstly, that drug users or abusers are the most prominent patient crowd of the ERs. This leads to the next conclusion that in order to improve ER services, we must be able to identify and care for the main target patients, who are drug users, alcoholics and such related substance abusers.
ER is also a most likely place where screening for psychiatric symptoms and drug abuse can be identified, and further treatments carried out. In this way, an ER can be looked at as a diagnostic, screening and treatment facility for those who are substance or drug abusers, with or without psychological symptoms.
This also means that in order to improve services in the ER, the prime patient population in focus should be such people, and effective measures and policies must be introduced to provide care for this group. The costs utilized in the education and prevention of alcohol abuse is far less than the costs that it takes to treat alcohol cases.
The trend in opting for emergency visit initially may have been limited to emergency cases, but in the recent years has grown to include insignificant calls that may not need emergency initiatives. The problem lies in lack of awareness among people about what constitutes an emergency and what not.
To many this increase in the recent years in the emergency room entries and calls are due to the increasing size of the populations, the reduction of services and number of hospitals, the decrease in the number of nurses, and the problems of not having insurance and coverage in the American population. The current concept of ER has changed to become a place that provides round the clock services for all healthcare related problems instead of a service that is essentially made to save lives in critical danger.
The complications are leading to more admissions, with the danger that many patients who may be in actual need of the critical treatment may experience delays in their treatment, leading to significant morbidity and mortality. (Severson, 2000) The current statistics reveal that one in five of the visits to the ER are for non-urgent conditions. (Osheraoff, 2004)
Of the most common abusers of the ER system, men, poor families and African Americans are seen to abuse them the most. These numbers are high in all of the American states. In California, this includes a quarter million of the Californian adults and 60,000 children.
The increase these admissions and care treatments cost are six times more than the normal clinical expenditures. Of the abusers, the non citizens were more likely to utilize the ER services when compared to the citizens. All these increases in the numbers are thought to take place due to the reasons mentioned above. The ER services nation wide are in deep trouble. (Sacremento State News, 2004)
In the last ten years from 1993 to 2003, America as experienced an increase of 12 percent in its population, but the ER reports and admissions have increased by 27 percent. This was coupled by the closing of 425 emergency departments, 700 hospitals and 200,000 beds. This means that as the number of ER services is decreasing, the remaining services are experiencing a sharp rise in the admissions and therefore more work with lesser amount of quality provision. (Brown, 2006)
What many of the Americans refuse to acknowledge is that the ER visit is also costly for them, apart from the increased cost that the healthcare sector pays. This trend to have every thing taken care of in the ER is usually due to two reasons on the patients’ behalf. One is to save oneself from waiting for an appointment with the primary healthcare provider, and second is the lack of awareness among the Americans as to what constitutes an emergency. (Osheroff, 2006)
The drug related admissions in hospital ERs is increasing precariously. In 2004, there were near 2 million admissions in the ER for drug related mishaps, of which 1.3 million were due to drug misuse or abuse. (SAMSHA, 2006)
Of the 1.3 million, 30 percent comprised of illicit drug abuse cases, 25 percent were related to over the counter and prescribed medications, 8 percent were alcohol abuse cases in people under age 21, and the rest included combinations of illicit drugs, pharmaceuticals and alcohols in various combinations and percentages.
The drugs that were primarily involved comprised of cocaine, marijuana, heroine, stimulants, amphetamines and methamphetamines, PCP, Ecstasy and GHB in the largest amounts. The problem will continue to increase in number as many predict due to the increased number of teenagers and young adults taking up these substances. (Samsha, 2006)