So I saw the headline in my inbox today as part of my daily "news" update from ACEP:
and I thought to myself, "what in hell is going on in California?" I mean, I know it's all locusts and rivers running red with blood what with the budget crisis and the balance billing law and the mandatory nursing ratios, but I thought someone for sure would have told me that 20% of their patients were now walking out of the ER without being seen. I mean, I know people who work in California, and none of them have mentioned that they are living in a post-apocalyptic end time. So I clicked through to the article linked, a place called "Healthday.com":
Fortunately, there was a citation, of sorts, to the current article published in the Annals of Emergency Medicine (subscription required). I eagerly clicked over and read the following:
We studied 9.2 million ED visits to 262 hospitals in California. The percentage of left without being seen varied greatly over hospitals, ranging from 0% to 20.3%, with a median percentage of 2.6%.
So... median 2.6%? That's, uh, not too bad. We do better. Yay us? But it's not 20% either. So what's the deal with the breathless headlines? Oh, I see, 20% was the max, at ONE hospital. Yeah, that's pretty bad. But it doesn't quite jibe with the breathless headlines implying the problem is state-wide, does it?
So, it's a decent article, better than the dreck they often publish as "research," but I can summarize it fairly easily: blah blah blah, poor people at underfunded hospitals get shitty service, notify the press! It's completely unsurprising, an example of the category of EM literature I refer to as "proving the intuituvely obvious." There is an interesting corollary that they did not comment on -- that funded patients are much more likely to leave without being seen than uninsured/medicaid patients. This is in part because funded patients have higher expectations of customer service, and in part because funded patients are more likely to have other avenues to access care (i.e. a primary care doctor or specialist). But I digress. Yes, it's an important article because it does quantify the existing problem. But healthday's writer (or, more precisely their editor who wrote the headline) completely failed to understand the statistics and now this inaccurate statistic is being spread all over. And I'm annoyed.
Yeah, I know, I'm about six weeks away from yelling at the kids to get the hell off of my lawn.