Overcrowded emergency rooms are a critical and prevalent issue for healthcare facilities across the U.S., including our own Spokane Valley. I propose an Honors Project to perform independent research post-pandemic, diving into potential factors leading to the ‘reason for visit’ in the emergency room (ER) as well as solutions to relieve this overcrowding in an organized and implementable format. The desired outcome would be to provide substantial data and analysis to support the reason for overcrowding in ER and increase the availability of patient beds.

Patients visit the ER for a variety of reasons. The majority of these reasons for visit tend to be injury or chronic illness. One study researched the temporal distribution of ER visits in patients with migraine and other headaches. The results found that most visits peak from around 11:00-13:00 and 17:00-19:00. During the week, a peak was seen Monday-Tuesday. During the year, a peak was seen in march. A low number of visits were seen during night shifts, on Sundays, and in June. This specific study demonstrates an eb and flow in the emergency department that depends on time of day, day of the week, and even time of year that fluctuates. This example shows some factors into why there may be more people in the ER than usual. ( García-Azorín, et. al, 2021 ). Another retrospective study actually found that during the covid-19 pandemic, there was a decrease in the number of pediatric patients checked in to the ER ( Wärnhjelm, et. al, 2022 ). Substance use and mental health was studied and found to be reasons for ER visits. This included nicotine dependence, illicit drugs, and serious mental health problems. These results explain that the ER is sometimes used as an intervention for substance use and mental health ( Wang, et. al, 2023 ). Through these examples, one can see how not all ER visits are the same. Varying reasons for visit can be due to acute or chronic conditions.

Another strong influencer of ER reasons for visit have to do with insurance. Depending on insurance plans and their coverage, some patients choose to visit the ER or urgent care clinics instead of a primary care physician. A study done with the medicaid population looked into inadequate provider communication as a reason for high ER visits. The researchers found that there were a few specific factors that decreased medicaid visits during the study. These were: easy to understand provider explanations, provider’s respect for patients, and effective patient-centered provider communication ( Platonova & Carnes, 2023 ).

Another factor that influences primary care in an ER is with populations experiencing homelessness. To conclude, reasons for ER visits have many influencing factors and for different reasons post-covid. Healthcare facilities face many new and old challenges in the ER that should continue to be analyzed and improved over time. 

Bibliography

García-Azorín, D., Abelaira-Freire, J., Rodriguez-Adrada, E., González-García, N., Planchuelo-Gómez, Á., Guerrero, Á. L., Porta-Etessam, J., & Martín-Sánchez, F. J. (2021). Temporal distribution of emergency room visits in patients with migraine and other headaches. Expert review of neurotherapeutics , 21 (5), 599–605. https://doi.org/10.1080/14737175.2021.1906222

Platonova, E. A., & Carnes, K. J. (2023). Relationship Between Patient-Centered Primary Care Provider Communication and Emergency Room Visits in the Medicaid Population in North Carolina, United States. Journal of primary care & community health , 14 , 21501319231171430. https://doi.org/10.1177/21501319231171430

Sauro, K. M., O’Rielly, C. M., Kersen, J., Soo, A., Bagshaw, S. M., & Stelfox, H. T. (2023). Critical illness among patients experiencing homelessness: a retrospective cohort study. Critical care (London, England) , 27 (1), 477. https://doi.org/10.1186/s13054-023-04753-7

Wang, S., Shafique, S., Xiao, D., Barker, K., Wang, K., & Xie, X. (2023). Clusters of substance use and mental health variables with emergency room visits in U.S. adults: The 2020 National Survey on Drug Use and Health. Journal of affective disorders , 339 , 683–690. https://doi.org/10.1016/j.jad.2023.07.017

Wärnhjelm, E., Lääperi, M., Kuitunen, M., Helve, O., Puhakka, L., Harve-Rytsälä, H., & Salmi, H. (2022). Decrease in paediatric emergency room visits during the COVID-19 pandemic restrictions: A population-based study. Acta paediatrica (Oslo, Norway : 1992) , 111 (11), 2165–2171. https://doi.org/10.1111/apa.16498