ER Visit Leaves Many Confused

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If you've made a sudden trip to the emergency room and are now heading home, take a moment to think about something besides all that poking and prodding: Are you sure you know what just happened and what comes next?

There are approximately 115 million people who visit ERs annually in the United States, statistics suggest. But new research finds that more than 75 percent of emergency room patients leave the hospital not knowing what's wrong with them or what they should do about it.

While it's not clear why patients are missing important details about their health, the chaotic nature of emergency rooms could have something to do with it, said the study's lead author, Dr. Kirsten Engel, a former University of Michigan emergency medicine fellow who now teaches at Northwestern University.

"It's a difficult, loud, confusing place, and there's a lot of activity going on," Engel said. "It's also a place where people by necessity come in during situations where they're not feeling well, they're anxious and upset."

In 2003 and 2004, researchers from the University of Michigan and Northwestern University interviewed 140 emergency room patients in two Michigan hospitals. The study findings were expected to be published in an upcoming issue of Annals of Emergency Medicine and were released online ahead of print.

The researchers asked the patients about four subjects: their diagnosis, their care in the ER, what would happen next, and when they should return. Then the researchers compared the answers to information in the patients' charts.

Seventy-eight percent of the patients gave incorrect information, and more than half got something wrong in at least two of the four subject areas. More than a third misunderstood what their post-ER care entailed.

Meanwhile, only 20 percent of patients who had incorrect information believed they might not be clear on things.

The study didn't look at why the gaps exist or how they might affect health.

Doctors may be part of the problem, Engel said. "We are pressured by many other issues, and that leads us at times to not necessarily review the information in ways that the patient can understand or we present it in a way that's too rapid at the wrong time for a patient," he said.