Factors impacting patient overcrowding at University of New Mexico Hospital Emergency Department

Many hospitals in the United Sates are currently experiencing Emergency Department (ED) overcrowding.The University of New Mexico Hospital is no exception.The reason for patient visits can vary from a common cold to a major trauma.According to the National Hospital Ambulatory Medical Care Survey (NHAMCS), the most common ailments seen in the ED in 2003 were abdominal pain, chest pain, fever and cough, all of which accounted for one-fifth of all visits.The great variation for patient visits and the fact that overcrowding is now a major concern has many administrators and healthcare providers re-evaluating the "appropriate" use of the Emergency Department.Many patients utilize the Emergency Department as their primary source of healthcare.It was recently reported that Emergency Department utilization in the United States increased from 90.3 million to 113.9 million annual visits, an average increase of 2 million per year (NMAMCS study).At any given day patients may find themselves waiting hours on end to be seen by a physician.The NHAMCS found that in 2003 fourfifths of ED visits were between 1-6 hours and average time spent in the Emergency Department was 3.2 hours.Recent studies have considered several contributing factors as the core of this major overcrowding problem.Included among these factors are method of payment, insufficient referrals to primary care physicians, over-representation of specific demographics presenting to the Emergency Department, lack of access to primary care, and lack of insurance.In the article The Role of the Emergency Department, published in The New England Journal of Medicine, Dr. Robert Steinbrook notes that in 1993 the annual excess