Date of this Version
American Journal of Emergency Medicine
Emergency department (ED) wait times have continued to worsen despite receiving considerable attention for more than 2 decades and despite the availability of a variety of methods to restructure care in a more streamlined fashion. This article offers an economic framework that abstracts away from the details of operations research to understand the fundamental disincentives to improving wait times. Hospitals that reduce wait times are financially penalized if they must provide more uncompensated care as a result. Pending changes under the Patient Protection and Affordable Care Act are considered. We find that the likely effect of the Patient Protection and Affordable Care Act's insurance expansion is to reduce this penalty for improving ED wait times. Consequently, mandating adoption of solutions to ED crowding may be unnecessary and counterproductive. If the insurance expansion is insufficient to fully solve the problem, the hospital value-based purchasing initiative should adopt wait times as a goal in its next iteration.
© 2013. This manuscript version is made available under the CC-BY-NC-ND 4.0 license.
Becker, N. V., & Friedman, A. B. (2013). ED, Heal Thyself. American Journal of Emergency Medicine, 32 (2), 175-177. Retrieved from https://repository.upenn.edu/hcmg_papers/45
Date Posted: 27 November 2017