MEMPHIS, Tenn. — The inability of poor Americans to get prompt emergency medical treatment is a crisis situation getting worse, a University of Tennessee physician said Tuesday.
Dr. Arthur Kellermann, in an editorial in the current issue of the Journal of the American Medical Association, said the nation’s health care delivery system ”itself has become too sick to wait” for treatment.
Kellermann, emergency medical director of the Regional Medical Center in Memphis, is a member of the American College of Emergency Physicians’ task force on hospital overcrowding. He cited studies that say emergency rooms of the nation’s public hospitals no longer function ”as America’s ‘health care safety net’ for our urban poor.
”America’s health care system is increasingly unable to meet the basic needs of a substantial segment of our population,” Kellermann said.
”Ten years ago, no one could have anticipated the crushing burden that AIDS, drug abuse and violence would place on our nation’s hospitals. Few believed that our patchwork quilt of health care programs for the poor, the elderly and the uninsured would fray so quickly.”
The breakdown, Kellermann said, is due to government cutbacks in financial support for community clinics, private hospitals converting space to drug and alcohol treatment, some hospitals going out of the emergency room business, and a severe shortage of nurses.
Kellermann said recent studies at two California hospitals show that a substantial number of emergency room patients with potentially serious problems are leaving without being seen.
Poor people go to hospital emergency rooms because they are always open, require no prior arrangements and no pre-payment at the door, provide laboratory and x-ray work, and can fill prescriptions, Kellermann said.
The American College of Emergency Physicians has proposed five changes in the nation’s health care policy:
* Increased capacity to provide critical care, inpatient and nursing home services.
* More government financial support for hospitals which provide a disproportionate share of emergency care.
* Tuition credits, higher salaries and increased professional responsibility to attract more people into nursing. ”In virtually every city, entire hospital floors and fully equipped intensive care units lie vacant because hospitals cannot recruit enough nurses to staff them,” Kellermann said.
* Increased access to primary and preventive health services.
* A basic level of health insurance for all citizens.