SPOKANE, Wash. — A team of researchers led by a Washington State University health policy researcher has identified delays and access problems for emergency medical care affecting almost 3 million Americans.

The findings of Jae Kennedy, associate professor of health policy and administration at WSU Spokane, are being published in the May 2004 issue of “Annals of Emergency Medicine.” The publication is a peer-reviewed journal of the American College of Emergency Physicians, a national medical specialty organization with nearly 23,000 members.


“Emergency departments are the front line of the American health care system, and problems in this area reverberate throughout that system,” Kennedy said. “Our federal policy objective of eliminating access barriers to emergency care is laudable, but many hospital emergency departments struggle with growing demand from the poor and uninsured.”

The ACEP news release is included below. To obtain copies of the article, contact Colleen Hughes, ACEP, at (202) 728-0610, ext. 3010, or by e-mail at chughes@acep.org.

Meeting Healthy People 2010 Objective to Decrease Emergency Care Access Barriers Looks Doubtful

A new study indicates that the United States emergency medical system has a long way to go to reach a federal objective to reduce the number of persons who are delaying or have difficulty in receiving emergency medical care (Access to Emergency Care Restricted by Long Waiting Times and Cost and Coverage Concerns, p. 567).

In a recent analysis of the 2001 National Health Interview Survey, researchers found an estimated

2.8 million adults who sought care in hospital emergency departments reported delays or access problems. Waiting times were the most frequently noted cause of problems; concerns about the cost of emergency medical services and insurance coverage were also commonly cited access barriers. Access problems were more likely to be reported by patients who were young, poor, and uninsured, and those in worse health were disproportionately at risk.

To meet the Healthy People 2010 objective to eliminate access barriers to emergency care, the study’s authors, led by Jae Kennedy, PhD, of Washington State University, suggest hospitals need to make operational changes to reduce emergency department treatment delays and health care financing policies need to be developed to reduce insurance coverage inequities.

“Many emergency departments around the country are experiencing increased volume and inadequate resources as they struggle to comply with an unfunded federal mandate to provide care to all regardless of ability to pay,” said study author Karin Rhodes, MD, from the University of Chicago.

“This situation is compounded by low Medicaid reimbursement rates in the primary care sector, which has made it harder for publicly-insured patients to obtain care anywhere except in emergency departments. The ripple effect is a paradoxical decrease in access to emergency care for everyone—insured and uninsured alike. Thus, our capacity to care for medical emergencies in our communities is being threatened. These access problems will continue to get worse until there is a coordinated national plan to provide health care for the poor,” Rhodes said.

In addition to Dr. Kennedy and Dr. Rhodes, other study authors are Craig A. Walls, MD, PhD, from Johns Hopkins University in Baltimore, and Brent R. Asplin, MD, MPH, from Regions Hospital and Health-Partners Research Foundation in St. Paul.

Kennedy, an associate professor in the department of health policy and administration, has published previously on drug costs as barriers to access, most recently in the April 2004 issue of Clinical Therapeutics.

Web sites:

Department of health policy and administration Web site: www.hpa.spokane.wsu.edu

WSU Spokane: www.spokane.wsu.edu

American College of Emergency Physicians: www.acep.org

Drug Costs a Barrier to Prescription Compliance for People with Disabilities: News release on previous research by Kennedy published in the American Journal of Public Health: http://wsunews.wsu.edu/detail.asp?StoryID=3139 (July 8, 2002)

Drug Affordability a Barrier to Access for Many Americans: News release on Kennedy research published in Clinical Therapeutics: http://wsunews.wsu.edu/detail.asp?StoryID=4556

College of Nursing news release on prospects for nursing graduates: http://wsunews.wsu.edu/detail.asp?StoryID=4553