As healthcare workers face historically high rates of burnout, the impact of America’s struggling hospital system is trickling down to waiting rooms.
Patients all across the country are facing exceptionally long wait times in emergency departments (EDs) – with patients in some states waiting more than four hours for treatment.
The average duration for patients from the time they first register in the ED, to the moment they are sent home from the hospital varies widely across the country.
In those in areas with speedy departments, you can be seen in one hour and forty minutes – while in more delayed areas it’s more than four hours.
Aside from the annoyance, long wait times can cause life-threatening complications, putting patients’ health in jeopardy.
The average nationwide time spent in the ED before getting discharged is two hours and 45 minutes.
But nearly half of US states exceed this, with Maryland having the longest hospital wait times – 247 minutes, just over four hours.
Tied for second are Massachusetts and Rhode Island at 214 minutes.
Delaware (211 minutes), New York (202 minutes) and New Jersey (194 minutes) round out of the top five, according to data from the Centers for Medicare and Medicaid Services, analyzed by pre-settlement legal funding company High Rise Financial.
Spending more time in the emergency department increases the chances of complications like infections and the risk patients will leave before being treated.
The bottom five states, where patients can expect to be in and out of the ED in two hours or less, include North Dakota (107 minutes), Nebraska (114 minutes), South Dakota (115 minutes), Oklahoma and Iowa (117 minutes) and Hawaii (120 minutes).
Long ED wait times have been plaguing hospitals for years. A study conducted more than a decade ago found longer durations were associated with an increased risk of hospital admission or death within seven days.
Although the overall risk is low, risk of hospital admission increased by up to 95 percent, while risk of death increased by up to 79 percent among the sickest patients.
A separate 2018 study found prolonged wait times in the ED are associated with increased death and decreased patient satisfaction.
Dr LouAnn Giangreco, a board-certified emergency medicine physician and the chief medical officer of American Family Care, a network of urgent care clinics, told DailyMail.com emergency wait times are often a sign of an area’s overall health ecosystem.
She said the length of stay in an ED is, ‘really dependent upon the whole health ecosystem that wraps around that emergency department,’ which includes resources in the community and access — of lack thereof — to preventative care services.
When the surrounding area doesn’t have reliable or quality everyday healthcare services, ‘it makes the emergency department a safety net’ for all conditions — including non emergent ones..
As burnout among healthcare practitioners skyrocketed during the Covid pandemic, hospitals felt the effects of staff and supply shortages.
Dr Giangreco said: ‘The other end of it is what’s happening within the hospital system.
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‘If that hospital system has a limit in the number of beds that they have, it prevents individuals from being able to go up into the hospital to be able to be cared for.
‘So they’re kept within the emergency department for care when they really need to be up on the hospital floors.’
In addition to the lack of routine care, Dr Giangreco said mental health in the ED is becoming an increasingly common issue.
Part of the ‘catch all’ nature of the emergency department is people coming in with behavioral health problems who have limited access to care in the community, which leads to the overcrowding of waiting rooms.
To address the issue and improve care, Dr Giangreco stressed the importance of being able to access routine preventive care, which would maintain a person’s health and decrease the chances of a complication requiring a trip to the ED.
Increasing telehealth and urgent care services can also provide faster and more accessible ‘in-between’ healthcare.
Supporting doctors, nurses and advanced practice practitioners (APPs) so they don’t get burnt out and leave hospital systems is vital to reducing ED wait times and improving patient care.
Maryland leads the country for longest ED wait times and is a state that is no stranger to topping lists when it comes to hospitals or healthcare, previous DailyMail.com reporting has found.
Dangerous medical blunders resulting in death or serious injury more than tripled in hospitals across the state between 2019 and 2022.
A report from the state showed there were 832 adverse events from October 1, 2021 to September 30, 2022, which was also the highest since records began in 2004.
Of the incidents, 769 were classified as the most severe, or Level 1 events, defined as adverse incidents that result in death or serious disability.
In one case, a patient went in for surgery on one of his legs and ended up having his other amputated due to a serious medical complication.
In another instance in 2021, three people died after a maintenance worker inadvertently shut off an unlabeled oxygen line.
Another blunder saw a premature infant with a low birth weight given the incorrect dose of steroids for nearly two weeks.
The overall events in 2022 were a 52 percent increase from 2021, and the highest the state has ever recorded since it began compiling data in 2004.
The report, which partially blamed dwindling staff and supply shortages during the Covid-19 pandemic for the increase in adverse events, included outcomes from 62 hospitals throughout the state of Maryland, but did not state what hospitals which events occurred in.
The Leapfrog Group, a private organization that evaluates hospital safety metrics, ranked Maryland 35th for patient safety and only gives nine hospitals in the state its highest safety rating of Level A.
The overall events in 2022 were a 52 percent increase from 2021, and the highest the state has ever recorded since it began compiling data in 2004.
The report, which partially blamed dwindling staff and supply shortages during the Covid-19 pandemic for the increase in adverse events, included outcomes from 62 hospitals throughout the state of Maryland, but did not state what hospitals which events occurred in.
The Leapfrog Group, a private organization that evaluates hospital safety metrics, ranked Maryland 35th for patient safety.
The body only gives nine hospitals in the state its highest safety rating of Level A.
Based on the findings, the authors of the report stressed hospitals should prioritize safety and optimize processes to prevent system failures that could lead to serious errors.
Also leading in Maryland, rates of Alzheimer’s disease.
The state of Maryland holds the top spot for the highest rate of Alzheimer’s disease in the United States, despite it faring better in obesity rates, household income and residents with health insurance.
The traditionally Democratic state nestled next to the nation’s capital has more than one in eight over people 65 years and older with the condition, compared to around one-in-10 nationally.
Maryland is also the only state to have two counties with the top-10 highest Alzheimer’s rates.
Baltimore City was tied for first place with 16.6 percent of people older than 65 years old and Prince George’s County was fourth with 16.1 percent.
Dr Kumar Rajan, author of the first-ever report of Alzheimer’s rates at the county level published in The Journal of the Alzheimer’s Association last year, said prevalence of the disease in Maryland is due to a higher number of Black and Hispanic residents.
These minority groups may have elevated rates of the dementia, health experts say, because they have higher incidences of heart disease, diabetes and high blood pressure – all conditions that impact brain health.
Previous research has shown older Black Americans are twice as likely to have Alzheimer’s or other dementias than older whites and older Hispanics are about 1.5 times more likely to have the disease than their white counterparts due to confounding factors of comorbidities and social aspects, such as racism and discrimination.
In addition to coexisting medical conditions, the Alzheimer’s Association said the higher prevalence of Alzheimer’s among Blacks and Hispanics can likely be explained by health and social disparities, as well as the marginalization and discrimination of these groups in the United States, which has been deeply rooted in history.
Dr Keith Vossel, the Alzheimer’s Disease Program Director in the department of neurology at the University of California Los Angeles, previously told DailyMail.com marginalized groups experience stress, violence, discrimination and racism. All of these life experiences can influence epigenetic changes, which alter the way a gene is expressed.
While Dr Giangreco couldn’t definitively say why Maryland is experiencing the highest wait times, she said it is important to examine a hospital’s staffing, quality measures and errors in order to get to the root of the cause – and begin to address it.