Compare NYC EM programs

[gro2001]

In what way? I was thinking it was a good move for the Sinai system. Is the difference of one ED - with the proliferation of urgent care centers over the past few years - really going to squeeze NYC's emergency care providers?

When St Vincent's closed in 2010, it definitely put a strain on the rest of the down town hospitals. That particular change probably affected the outpatient world more than the EDs (in particular, St Vincent's HIV program was a very important part of the HIV infrastructure of NYC), but it was definitely something that ERs felt at the time.

In 2012 when NYU and Bellevue temporarily closed their ERs in the aftermath of Hurricane Sandy, it was full on disaster mode until they re-opened. Even afterwards, repercussions were felt for quite a while. Those two closing drastically transformed the landscape for hospitals quite far away. Patients in hallways went from being a sometimes thing to a permanent thing. In my hospital we had to open a new inpatient ward, literally in the lobby of the hospital. That remained the case for months, and even continued after those EDs re-opened.

NYC's infrastructure isn't very flexible to sudden changes. It's almost impossible to build a new hospital. Even additions to existing ones take decades. So yes, a hospital closing could have very tangible effects on ED operations in the city.

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[Perfect Hair Day]

When St Vincent's closed in 2010, it definitely put a strain on the rest of the down town hospitals. That particular change probably affected the outpatient world more than the EDs (in particular, St Vincent's HIV program was a very important part of the HIV infrastructure of NYC), but it was definitely something that ERs felt at the time.

In 2012 when NYU and Bellevue temporarily closed their ERs in the aftermath of Hurricane Sandy, it was full on disaster mode until they re-opened. Even afterwards, repercussions were felt for quite a while. Those two closing drastically transformed the landscape for hospitals quite far away. Patients in hallways went from being a sometimes thing to a permanent thing. In my hospital we had to open a new inpatient ward, literally in the lobby of the hospital. That remained the case for months, and even continued after those EDs re-opened.

NYC's infrastructure isn't very flexible to sudden changes. It's almost impossible to build a new hospital. Even additions to existing ones take decades. So yes, a hospital closing could have very tangible effects on ED operations in the city.

Wow, I didn't realize. Thank you for taking the time to write all this out and explain

 

[alpinism]

In what way? I was thinking it was a good move for the Sinai system. Is the difference of one ED - with the proliferation of urgent care centers over the past few years - really going to squeeze NYC's emergency care providers?

The Squeezing is all relative.

Manhattan only has a population of 1.6 million and will still have no less than 12 ERs once Beth Israel closes.

The problem is that everyone uses the ER as their personal 24/7 primary care clinic since they don't want to schedule an appointment.

 

[gro2001]

The Squeezing is all relative.

Manhattan only has a population of 1.6 million and will still have no less than 12 ERs once Beth Israel closes.

The problem is that everyone uses the ER as their personal 24/7 primary care clinic since they don't want to schedule an appointment.

That's the night time population of manhattan. The day time population is closer to 4 million.

I realize that it might sound a little #FirstWorldProblems to bemoan the ER situation in Manhattan when there are so many communities that are way more underserved, but even considering some conservative numbers:

Population of Manhattan:1,600,000
https://www1.nyc.gov/assets/plannin...c-population/projections_briefing_booklet.pdf

ED visits in Manhattan: 553,874
Table 1: 2006 Emergency Department Visits by County of Residence and Age

Manhattan ED visit rate: 34%

US population: 326,000,000
Population Clock

ED visits in US: 141,000,000
FastStats

US ED visit rate: 43%

US Emergency departments: 5,000
National Emergency Department Inventory
How many emergency rooms are in America | BellaireER | BellaireER

US population/ED: 65,200

Manhattan EDs: 12

Manhattan population/ED: 133,300

So residents of Manhattan visit Emergency Rooms less frequently than the national average. This difference is probably even greater, since as I mentioned above Manhattan's population doubles during working hours. Also, at least one of the reasons that Manhattan EDs are overcrowded, is that we have half as many as the national average.

The data on admission rates and other ways of evaluation sickness is also interesting. I am not going to demonstrate it here, since it's all over the place and I really get some work done on my actual research, but basically the suggests that while a lot of New Yorkers' visits are non emergent or preventable, this is also true for the rest of the country as well, and actually maybe New Yorkers are not as bad as you think. Our admission rates, including to the ICU are higher, for example. Now, of course this is multi factorial and not only linked to New Yorkers' hardiness. But it seems to me that the over crowdedness of NYC ERs may have less to do with indiscriminate utilization as you imply, but more with overall availability and accessibility of health care services.