ACEP has called for hospitals to implement the full-capacity protocol, which Gardner says hospitals have been reluctant to embrace.
Gardner says the problems of long ED waits will worsen with the implementation of federal healthcare reform laws, which will expand health insurance coverage to more than 30 million people.
"Policymakers and the public should also have no illusions that the recently passed healthcare legislation is going to decrease ER use," she says. "Massachusetts, which enacted healthcare reform in 2006, has seen an increase in emergency department visits, with no decrease in patient acuity. It proves that healthcare coverage is no guarantee of healthcare access."
Exacerbating the problem even more, Gardner says, is the number of EDs that have closed in recent years. "More patients plus fewer ERs equals longer wait times," she says. Early one-quarter of hospitals report periods of ambulance diversion because they are over capacity. A longer ride to the hospital is not good medicine."
Utah had the longest wait, with an average emergency department time of 8:17—early an hour and a half longer than the state's average time spent last year. Iowa had the shortest average time spent at just under three hours (2:55), followed by South Dakota (2:59), North Dakota (3:07), Nebraska (3:08) and Minnesota (3:11). More than half the states were able to improve wait times or keep increases to a minimum. Nevada made the biggest improvement in 2009, reducing average wait time by 66 minutes since 2008.
"This report is yet another wake-up call that healthcare reform has yet to address the acute care needs of 123 million emergency patients a year," Gardner said. "They may report being satisfied with the care they are receiving in the ER, but emergency physicians are dissatisfied with an average time in the emergency department that is nearly equal to a coast to coast airplane ride."