Heroin killed 918 people in Maryland in the first nine months of 2016 alone. It could also be behind the climbing emergency wait room times across the state.
“We've actually seen an 18 percent increase in mental health and substance use related emergency visits when other emergency department visits are going down,” said Carmela Coyle, President and CEO for the Maryland Hospital Association.
The number of overall patients to the emergency department has decreased in the last few years, while the number of behavioral health visits increased by 11 percent in 2015 compared to 2013.
“We're actually treating more mental health and substance abuse patients and they're taking longer to treat,” said Coyle.
An average of three hours more, according to the Maryland Hospital Association. Behavioral health patients are in the ER over 12 hours while non-behavioral health patients typically take no more than nine hours.
The organization, like many state officials, is grappling with how to address mental health and substance abuse but they're also dealing with a nursing shortage.
“We're seeing shortages of critical care nurses and intensive care unit nurses, which makes it difficult to move a patient once they're in the emergency department into those critical care units,” said Coyle.
They're working with nursing schools but still have vacancies, and on top of that they're trying to change community behavior.
“One of most important things we can do is really help our communities understand when to use the emergency department and when to use other more appropriate sources of care,” Coyle said.
While hospitals in our area continue to open urgent care and coordinated care facilities, the average ER wait time continues to climb leaving this decades-long problem once again in limbo.
“This ED wait time issue has been on and off for a very long time. We need to again check and see what those drivers are. We think they've changed and we need to work together to try and address them,” said Coyle.
Another theory has to do with the hospital payment system that's unique to Maryland. Hospitals in the state get paid an overall sum instead of per patient.
A board member with the American College of Emergency Physicians said he believes the cap on resources affects doctors and nurses abilities to care for everyone in a timely manner.
The Maryland Hospital Association said they don't think increased ER wait times has anything to do with the payment model.
The Maryland All-Payer Model was implemented in 2014. As far as the MHA is aware, no studies have been done on how the system directly affects the wait time at emergency departments.