abcnews.go.com
ER Boarding Crisis Impacts Dementia Patients
A data analysis reveals that "ER boarding," where patients wait hours or even days in emergency rooms for admission, disproportionately impacts older adults with dementia; this issue is driven by systemic problems within the US healthcare system, including a shortage of beds and financial incentives favoring profitable procedures.
- What are the immediate consequences of "ER boarding" for patients with dementia, and how prevalent is this problem?
- ER boarding," the prolonged wait in emergency rooms for hospital admission, disproportionately affects older adults with dementia. One in six hospital admissions in 2022 involved a four-hour or longer ER wait, with 50% of those being patients 65 and older. This results in significant distress for patients and their families, as illustrated by the cases of Bill Speer and Michael Reeman, both of whom experienced extended waits and subsequent negative impacts on their health and well-being.
- What systemic factors within the US healthcare system contribute to the rise of ER boarding, especially among older adults with dementia?
- The issue of ER boarding stems from a confluence of factors: a shrinking number of hospital beds (965,000 in 2003 vs 913,000 in 2023), increased emergency room visits (30%-40% increase since 2003), and hospitals prioritizing higher-paying procedures. This results in patients, especially those with dementia, being stuck in ERs for extended periods, worsening their conditions. Fewer available beds in behavioral health centers further exacerbates the problem.
- What policy changes or systemic solutions are needed to address ER boarding and mitigate its negative impact on patients with dementia and the broader healthcare system?
- The crisis of ER boarding will likely worsen due to the aging U.S. population and increasing dementia rates. The lack of sufficient beds, coupled with financial incentives favoring profitable procedures, creates a systemic issue. Without systemic changes addressing bed capacity, alternative care options, and financial incentives, patients with dementia will continue to face unsafe and dehumanizing conditions.
Cognitive Concepts
Framing Bias
The narrative strongly emphasizes the negative experiences of patients and their families facing long ER waits, using emotional anecdotes to highlight the human cost of ER boarding. While this approach is understandable, it could be perceived as biased against the healthcare system without fully exploring its complexities and the challenges it faces. The headline, while not explicitly stated in the prompt, likely focuses on the problem of ER boarding, framing it as a major crisis. This emphasis could potentially overshadow other important aspects of the issue.
Language Bias
The article employs emotionally charged language in describing the experiences of patients and their families, such as "yelling at the top of his lungs" and "enraged". While this adds impact, it also contributes to a potentially negative portrayal of the healthcare system. More neutral alternatives could be used in some instances. For example, instead of "yelling at the top of his lungs," "became very agitated" could be used. Replacing "enraged" with "concerned" or "advocating for change" would offer more balanced descriptions.
Bias by Omission
The article focuses heavily on the negative impacts of ER boarding, particularly for dementia patients, but offers limited exploration of potential solutions beyond systemic changes. While it mentions lobbying efforts by physician groups, it doesn't detail their specific strategies or successes. Additionally, the article doesn't explore alternative care models or innovative approaches that might alleviate the burden on emergency rooms. The article also omits discussion of the financial incentives for hospitals to prioritize certain types of patients and procedures over others, focusing more on the consequences of this system.
False Dichotomy
The article presents a somewhat simplistic dichotomy between the need for increased hospital beds and the financial constraints of the healthcare system. It suggests that increasing bed capacity is the primary solution, but doesn't fully explore the complex interplay of factors like insurance reimbursement policies, staffing shortages, and the overall structure of the healthcare system.
Sustainable Development Goals
The article highlights the negative impact of ER boarding on older adults with dementia, leading to prolonged suffering, potential worsening of their condition (delirium), and lack of dignity. The shortage of hospital beds and behavioral health facilities directly affects the timely and appropriate care for this vulnerable population, hindering progress towards SDG 3 (Good Health and Well-being) which aims to ensure healthy lives and promote well-being for all at all ages.