ER takes backseat to ball games

Visits to emergency rooms at Boston area hospitals plummet when the Red Sox play championship games.

During the biggest games, ER visits dropped between 5 and 15 percent below normal at six of the area hospitals. For example, during the Sox final game with the New York Yankees for the American League Championship and their final game of the World Series against the St. Louis Cardinals, visits to the emergency room dipped 15-20 percent below the normal volume.

Where did all those “sick” people go? Researchers at Children’s Hospital Boston, who monitor infectious disease outbreaks, checked outbreaks of local television watching with the help of Nielsen ratings and found a convincing match. A remarkable 55-60 percent of area households were tuned to the big game.

John Brownstein, Ben Reis, and Kenneth Mandl operate a surveillance system called AEGIS as part of Children’s Hospital Informatics Program at the Harvard-MIT Division of Health Sciences and Technology. This system keeps an electronic eye on hospital emergency departments in order to spot abnormal outbreaks and patterns of disease.

“We got caught up in Red Sox fever last year, and wondered if we could see an effect on patient use of emergency departments,” explains Brownstein. A previous study found an increase of drunk-driving deaths on Super Bowl Sunday last year. “We only looked at emergency department visits during the hours of the games, not afterward when fans might be driving,” Reis notes.

Reis and Mandl grew up in Boston. Brownstein comes from Montreal but admits to being “swept up in game fever.” Children’s Hospital is close enough to Fenway Park for doctors and patients to hear the shouting when the Sox are winning and the wind is right.

Sox give docs a break

The Red Sox lost the first three games of the American League Championship to the New York Yankees last year. During those games, ER visits exceeded the normal pace. Then the Sox won game 4. During games 5, 6, and 7, the number of patients visiting emergency facilities fell between 5 and 22 percent.

ER doctors enjoyed another respite during the four World Series games when the Sox swept the Cardinals.

The correlation is nicely presented in the October issue of the Annals of Emergency Medicine. Children’s Hospital Boston is an affiliate of Harvard Medical School, as are three of the other five hospitals in the study.

An obvious conclusion is that people would rather watch a good baseball game than go to the emergency room. Also obvious is that some people who go to the ER could just as well visit their doctor. The researchers put it this way: “These results suggest that engagement with televised broadcasts of major events is one factor in patients’ decisions to seek emergency care.”

“Timing of emergency department visits has a strong discretionary component,” Brownstein adds. Asked if that meant a lot of people who go to the ER do not need to go there for health care, he answered that the study data does not warrant such a negative conclusion.

Brownstein also points out that disease surveillance systems like AEGIS are funded primarily to detect bioterrorism attacks, but have multiple other uses, including detecting natural outbreaks of disease and monitoring trends in people seeking health care. For example, he and his colleagues currently use AEGIS to for determining the best strategies for flu vaccinations.