Portland-based Oregon Health & Science University said it is facing financial issues due to its overcrowded emergency department and having to divert patients seeking specialty care and elective surgeries, Oregon Public Broadcasting reported April 21.
The number of patients admitted to the emergency department has climbed from 28% to 40% of total admissions in the last five years, the hospital said in a presentation to the board. The rise in admissions has been complemented by difficulties to discharge patients into rehab or care facilities, leading to ED boarding and some patients seeking cancer, neurologic and cardiovascular care being turned away. These three specialties are key moneymakers for the hospital, and their depletion has contributed to a $44 million operating loss over the last nine months.
Inpatient units have overflowed and some patients have been staying in conference rooms, hallway beds and exam rooms. Hospital transfers are down by 47% over five years and the hospital operates regularly at 95% capacity.
Emergency department boarding and capacity issues have plagued hospitals and systems for the last few years. ED boarding can be caused by a variety of factors, including workforce and staffing challenges, transparency and reimbursement issues with payers, inadequate resources for mental healthcare and barriers to discharging patients to other inpatient services, according to the report.
"Boarding is causing widespread dysfunction, and we feel it every day," Aisha Terry, MD, president-elect of the American College of Emergency Physicians, said during a presentation of its report on ED boarding. "It won't happen overnight, but we are one step closer to solutions because we are coming together."