Area residents rank 1st in nation for visits to ERs

3/21/2005

Granted, Toledo is known as the Glass City, but apparently we're more breakable than folks elsewhere based on the results of a survey on how often people go to a hospital emergency room.

For the second year in a row, the Toledo area - which in the survey includes 12 northwest Ohio counties and Lenawee County, Mich. - ranked first in the nation last year when it comes to the number of residents who went to an emergency room.

Scarborough Research, a New York City marketing research firm, last year randomly surveyed more than 200,000 adults in 75 designated market areas of the country. Among the questions the firm asked was whether anyone in the household had been to the emergency room in the last three years.

In the Toledo area, 57 percent of those surveyed said someone from their household had gone to the emergency room in the last three years.

We beat out the Motor City: Detroit reported 45 percent. We trounced Sin City: Las Vegas was dead last at 38 percent. The average was 46 percent, found in places like Grand Rapids, Mich., and Rochester, N.Y.

That means Toledo-area residents go to the emergency room 26 percent more than the average of areas surveyed. A fluke, you say? Well, after examining Scarborough's numbers in a little more detail, maybe they're on to something.

In 2002, Toledo tied for second at 47 percent of households having visited an ER, and in 2003 we were on top at 54 percent. If anything, Toledo-area residents are apparently getting sicker. Or maybe not.

Dr. Kris Brickman, medical director of the Medical College of Ohio's emergency department, said there could be a lot of factors influencing this area's top score.

"Are people sicker here? I don't know. We obviously smoke more," he said, pointing to Toledo's high smoking rate.

One theory he offered was that most area emergency rooms do a good job of quickly getting people treated, so people use the ER more here. In bigger metropolitan areas, long waits are common, so more people in those areas may choose to go to their doctor or do nothing rather than head to the ER.

Another possibility might be a lack of primary-care access. If patients lack insurance or don't have a regular doctor, maybe they turn first to the emergency room, Dr. Brickman said.

Officials at Scarborough Research weren't much help explaining why Toledo came out on top. The question about ER use is just one of hundreds of questions the firm asks in its surveys. The company sells these results to advertisers and other clients, according to Allyson Mongrain, a Scarborough spokesman.

Ms. Mongrain said the company bases its results on random phone calls, as well as follow-up questionnaires mailed to respondents. She said the results have a margin of error of plus or minus 3 percentage points.

If area patients really are turning to an emergency room before trying their physician's office, that would have a dramatic effect on health-care costs, according to Benjamin Goff, president of Great Lakes Risk Management, a Toledo-based health insurance broker for area businesses.

Mr. Goff, who said he was "astounded" by the Toledo area's top ranking, said an average doctor's office visit might cost $60 or $70 - but a trip to the ER can routinely cost $400 or more. Maybe our area is full of some of the sickest people around, Mr. Goff said, adding the high smoking rate doesn't help. But he said if the Scarborough figures are accurate, the blame probably rests largely with consumers.

"The finger needs to be pointed to the patient. This is clearly the consumer's fault. You don't go to the ER unless it's an emergency," he said. "I mean, our health-care costs are some of the highest in the country. We don't need a ranking like this. From an economic perspective, if I was a business looking to locate somewhere, why would I come to northwest Ohio?"

How many people pay attention to surveys like this is hard to determine. However, The Washington Post ran a short item earlier this week about the rankings and pointed out Toledo's top spot.

Marja Dooner, director of the trauma and emergency department at Toledo Hospital, the area's busiest emergency room with more than 70,000 ER visits annually, said she has no idea why our area ranks so highly.

"I don't know if it's something in the air or what," she said, laughing.

Whatever the reason, Ms. Dooner said her emergency room has been getting busier the last few years.

Dr. Brickman agreed, saying the annual volume at his department at MCO was about 19,000 patients six years ago and is around 25,000 patients now.

St. Vincent Mercy Medical Center, the area's second-busiest emergency department, averages about 60,000 visits annually, a number that has been fairly stable for the last three years, said spokesman Sarah Bednarski.

The Toledo area finished well ahead of New Orleans, the second-place finisher in the survey.

After that, there were numerous cities tied with each other percentage-wise as a result of the margin of error.

Contact Luke Shockman at: lshockman@theblade.com or 419-724-6084.