Emergency room overcrowding nationwide

While UMC’s use of an “internal disaster” alert following the Oct. 1 mass shooting on the Strip violated county policy, emergency management experts from other jurisdictions contacted by the Review-Journal couldn’t say whether the move was inappropriate. That’s because hospital codes aren’t nationally standardized, and without standardization, crosscountry research and review of emergency response is stunted, they say.

During a recent tour of the Las Vegas dispatch communications center, Assistant Fire Chief Sarah McCrea said the frequent use of internal disaster alerts by some hospitals is justified.

“It’s a busy system,” she said. “Yeah, it’s frustrating from an EMS perspective because there’s bottlenecks, but there’s bottlenecks everywhere.”

Diversion was first examined as a potential solution to emergency department overcrowding in a 1990 journal article, according to a 2016 article by the peer-reviewed journal Health Affairs and the Robert Wood Johnson Foundation.

While the Obama administration hoped expanded access to insurance under the Affordable Care Act — also referred to as “ObamaCare” — would lessen emergency room demand, ER visits in Nevada increased nearly 20 percent between 2013 and 2016, far beyond the 5 percent growth in population, according to data from the Nevada Hospital Association.

In the same period, the number of uninsured Nevadans fell 52 percent, the data show.

UMC CEO Mason VanHouweling partly attributed ER overcrowding to the ACA in an emailed statement, stating that at the hospital and nationwide, access to insurance has increased ER use. He also cited the aggressive flu season this winter as reason for emergency patient influx.

Jessie Bekker