Surge in Emergency Department patients linked to job cuts

FRIDAY, JUNE 29: More people are using emergency services because they have lost their jobs and no longer have health insurance, a top doctor said yesterday.

Dr Ed Schultz, director of emergency services at the King Edward VII Memorial Hospital, said: “Patients tell us they’re coming to the emergency department as they no longer have health care coverage because they have lost their jobs.”

Dr Schultz said that the spike in numbers seen in emergency and the Lamb Foggo Urgent Care Centre coincided with the recession.

He added: “The recession is likely to be a contributing factor, however, we do not have statistics to verify this.”

Emergency department staff saw a total of 39,584 patients in the financial year to March 31 compared to just over 39,000 in 2010-11.

But others said they had predicted back in 2007 when hospital clinic known as the ‘indigent clinic’ was closed amid protests that the move would lead to increased pressure on the Emergency Department.

Government said at the time that patients that used the clinic would be able to register with GPs instead.

Jenny Brooks, who led the campaign to save the clinic, said: “That’s definitely part of it.

“It’s not the entirety of the reason, but a factor for sure and we said that in 2007. It’s very sad with the economic situation Bermuda’s now getting into.

“There are a lot of patients who wouldn’t be able to get with these private doctors, so a rise in emergency room visits is not surprising at all.”

Dr Schultz added that an ageing population was also a contributory factor to the increase in people seeking emergency care – a problem seen across developed countries.

He said that many elderly patients often had a number of problems – including diabetes, heart disease and kidney disease.

Dr Schultz added: “The fastest growing segment of the population in these countries is now patients over 80 years old. When these patients become ill, they are often very sick requiring emergency stabilization and hospitalization.”

Health Minister Zane De Silva earlier this month urged people with minor complaints not to clog up the emergency department but to see their GP instead.

Mr De Silva was speaking as he unveiled three medical package proposals to make health care more cost effective as part of the National Health Plan, to be launched in 2014.

Dr Shultz said that advice on when to use emergency care varied from patient to patient, with age, overall health and underlying medical conditions all having to be considered.

He added: “Minor complaints such as sore throat, viral upper respiratory complaints, ear aches, sprains, muscle injuries, flares of chronic arthritic conditions, long-standing aches and pains, most skin rashes, uncomplicated urinary tract infections issues with blood pressure or blood sugar control, weight loss, sleeping and eating disorders and general malaise are best managed by a patient’s GP, who is familiar with their prior medical history and pre-existing medical conditions.”

Dr Shultz said: “In general, patients with acute airway problems, significant traumatic injuries, possible shock, head injuries with altered mental status, loss of consciousness or amnesia should all seek urgent help.

Other problems which should be treated as emergencies are suspected fractures of large bones, extensive cuts, all head injuries in patients on blood-thinning treatments like warfarin, possible strokes, severe weakness or paralysis, uncontrolled seizures and loss of consciousness, especially in the elderly and chest pain.

Dr Shultz added that changes in heart rhythm, shortness of breath and severe stomach pain or bleeding, severe burns, inhalation of toxic substances and severe allergic reactions would also need emergency department attention.

He said: “A significant percentage of these patients will require admission to the hospital and some will require surgical intervention on an emergency basis.”