Health reform, convenience drive emergency department construction

Expanded health coverage under the Affordable Care Act and hospital initiatives to provide faster, more convenient emergency services in rural and suburban communities have spurred a new wave of emergency department construction.

In Butler County alone, more than $8.4 million in emergency department (ED) upgrades or construction have occurred in the past two years.

Marking another $20 million in emergency care, the Kettering Health Network plans to build two freestanding EDs by 2015 in nearby Franklin and Eaton at a cost of about $10 million each.

“With these freestanding ERs, residents will have better and faster access to quality emergency care closer to home,” said Fred Manchur, chief executive officer of Kettering Health Network.

More than 360,000 Ohioans gained health coverage this year by enrolling in private plans sold through the ACA’s health care marketplace or qualifying for expanded Medicaid benefits.

Cutting down on wait times and providing closer, more convenient access for the residents of rural and suburban communities have been the driving forces behind new freestanding EDs being built to augment hospital emergency centers.

Like hospital EDs, freestanding centers are fully equipped to diagnose and treat acute conditions and severe trauma. But freestanding centers don’t treat as many of those patients as hospitals, so patients with less severe emergencies can get more immediate assistance.

Since 1990, the number of hospital-based emergency departments has declined by 27 percent, according to a study published in the Journal of the American Medical Association in 2011. Meanwhile, the number of visits to hospital EDs has been on the rise, increasing 30 percent — to 123 million — between 1998 and 2008 alone, the study found.

The use of hospital EDs is growing faster than the use of any other part of the U.S. medical system, according to the American Hospital Association, and EDs are now responsible for about half of all hospital admissions in the United States.

In Butler County, Cincinnati-based TriHealth opened a $3 million emergency department in February 2013 on the Bethesda Butler Hospital campus on Hamilton-Mason Road in Hamilton after purchasing the former Butler County Medical Center in 2012.

The new ED has 17 patient bays within about 11,000 square feet.

The Mercy Health network in June 2013 expanded its emergency department at Fairfield Hospital to include an extra six patient bays. The hospital spent about $400,000 on the expansion for a total of 38 patient bays in the ED, which recorded over 61,000 visits in 2012.

In Hamilton, the Kettering-owned Fort Hamilton Hospital underwent $5 million in construction to expand its emergency department to 35 patient beds.

The project was ongoing from August 2012 until completion in January 2014.

The Hamilton hospital has averaged about 40,000 annual visits to its ED in the past three years, but now has the capacity for as many as 60,000 patients per year, said Dr. Marcus Romanello, chief medical officer at Fort Hamilton Hospital.

Butler County’s youngest hospital, West Chester Hospital, hasn’t had the need yet to update its emergency services because it’s still modern in its design and technology, said spokeswoman Debra Titlebaum.

However, she said the hospital’s patient volumes and breadth of services in the ED have been on the rise.

There’s been a 20 percent increase in patient volumes in the past two years, with over 37,000 patients treated in the ED last year. Titlebaum said the hospital can also handle more complex cases after earning provisional status as a Level III Trauma Center from the state of Ohio last year.

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