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Healthcare Woes Show Up In Oregon Emergency Rooms

In a state where one in five adults has no healthcare, it’s reassuring to know that if you’re ill, you cannot be turned away from a hospital emergency room.  But there’s a problem.

A new report  finds that Oregon ranks 47th in the nation for the availability of emergency healthcare.

Kristian Foden-Vencil dropped in on the ER  at Oregon Health and Science University and filed this report.

You wouldn’t expect an emergency room to be busy at three o’clock on a Monday afternoon.

People aren’t out getting drunk and fighting; it isn’t rush-hour so the number of traffic accidents ought to be low; and this particular Monday wasn’t a holiday —so family members weren’t at each others throats.

But it was busy.

The  waiting room held more than a dozen people. Some  clutched their stomachs in pain; others held an arm or leg delicately; and some simply patiently waited in a wheelchair.

Inside the ER, nurses and doctors buzzed around, discussing cases and picking up syringes or medications.

Rows of medical room were filled with people in various states of undress, plugged into IVs or covered in bandages.

Doctor John Morehead was on duty. He’s been an emergency physician for 30 years.

John Morehead: “I’ve seen the demand for emergency service escalate. I’ve seen the number of hospitals and emergency departments locally an in this state, decrease. And so we reach a situation that exists today which is from day to day, almost a crisis situation, where we have tremendous demand for emergency services and fewer emergency departments.”

In room nine, an elderly woman had fractured her hip.

At the entrance, three people were brought in on long white stretchers in the course of an hour. And down the hall, a hospital staffer asked a patient if he knew where he was.

Organized chaos is the best description for what was going on.

In room 15, Judy Doble was stable, but had been bleeding internally for days.

Judy Doble: “I’ve been feeling weak and my doctor referred me here after I went to the clinic and had her check me out.”

Kristian Foden-Vencil : “And how long did you have to wait and how were you dealt with?”

Judy Doble: “They’ve always been really friendly, probably about a half an hour out there and I’ve been here now probably since 12:30.  It’s about 3:30 or 4 now.”

Kristian Foden-Vencil: “Have you had any other experiences in the ER’s.”

Judy Doble: “Most of them have been time consuming, but other that that, they’ve actually been very friendly.”

Doble is lucky, a new study by the ‘American College of Emergency Physicians’ found some patients in New York who had to wait 20 hours to get care. It also learned of at least 200 deaths around the country because of the practice of ‘boarding,’ where patients on stretchers line corridors until a regular hospital bed opens up.

While those conditions were not reflected here, statewide, Oregon ranked towards the very bottom in the nation for the availability of emergency healthcare.

Again, Doctor John Morehead.

John Morehead: “We have tremendous people who are well trained and motivated to provide excellent emergency care, working in a system that’s not working very well, that’s inadequately funded, and a reflection of an entire healthcare system that’s broken.”

The ‘American College of Emergency Physicians’ study looked at how states deal with everything from injury prevention to disaster preparedness. Oregon received a ‘D’ grade.

The report found that 19 percent of adults here don’t have health insurance; that no formalized stroke or heart attack care system is in place; and that Oregon hasn’t been recognized by the ‘Emergency Management Accreditation Program.’ 

Morehead acknowledges all those points. But he says little is going to change until the state and the federal government do  something about healthcare.

John Morehead: “We would actually like to see this state focus on emergency systems, emergency services. I think the Oregon College of Emergency Physicians believes that there should be even a governors task force that is set up to examine the system. To include the providers, to include the public, to include people who do research in this area, to come up with some formal recommendations that are workable for the state of Oregon.”

But the report wasn’t all about shortcomings. 

In fact,  Oregon ranked first in the nation for injury prevention efforts.  That’s because a lot of Oregonians get vaccinated; they tend to use seatbelts and many don’t smoke.

The state also has the Oregon Health Plan. Indeed, at OHSU, it the job of Barbara Perez to find patients some kind of coverage when they arrive in the Emergency Department, or ED.

Barbara Perez: “It’s basically after they’ve accessed the ED, we get a list of patients who don’t have insurance and then we try to help them obtain insurance to cover that ED visit or future visits. What happens is — we place what we call a hold with the Oregon Health Plan, so that the OHP will mail them an application. And they’re also directed to our department — if they need additional assistance.”

The report card comes at a bad time for the nation. Leaders are still focused on the wars in Iraq and Afghanistan along with global economic turmoil.  But President-elect Barak Obama has indicated that healthcare will be among his highest priorities when he takes office next month.

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