Below are some key points, but the entire article is worth reading at http://www.nytimes.com/2011/05/18/health/18hospital.html
Fewer Emergency Rooms Available as Need RisesBy Roni Caryn Rabin,
May 17, 2011
Hospital emergency rooms, particularly those serving the urban poor, are closing at an alarming rate even as emergency visits are rising, according to a report published on Tuesday.
Urban and suburban areas have lost a quarter of their hospital emergency departments over the last 20 years, according to the study, in The Journal of the American Medical Association. In 1990, there were 2,446 with emergency departments in nonrural areas. That number dropped to 1,779 in 2009, even as the total number of emergency room visits nationwide increased by roughly 35 percent....
New York City lost three hospital emergency rooms in 2008, two in 2009 and two more last year, when St. Vincent’s Hospital Manhattan in Greenwich Village closed, followed by North General Hospital in Harlem. St. Vincent’s had handled more than 60,000 emergency visits a year, while North General’s E.R. had recorded 36,000 annual visits.
A 24-hour emergency care and ambulatory surgery center, operated by North Shore-Long Island Jewish Health System, is planned for Greenwich Village. Neighborhood advocates have expressed concern that the free-standing emergency room will not be able to deliver adequate care without the backing of a full-service acute-care hospital.
The new study warns of delays in emergency care that are already playing out in the community, said Dr. David L. Kaufman, a member of the Coalition for a New Village Hospital who worked at St. Vincent’s for more than 30 years. Patients who would have sought care at St. Vincent’s, he said, “take longer to get to nearby hospitals in New York City traffic. They’re waiting many, many hours to be seen and managed, and if they require admission, they have to wait another 12 to 24 hours because there are no beds.”
So-called safety-net hospitals that serve disproportionate numbers of patients and hospitals serving a large share of the poor were 40 percent more likely to close.