When Red Sox Are Hot, ER Visits Cool

Sick or injured fans put troubles on hold to watch the game, study suggests

MONDAY, Sept. 26, 2005 (HealthDay News) -- A medical emergency is a medical emergency, right? Well, maybe not always for die-hard Boston Red Sox fans.

Researchers charting emergency-room visits in that baseball-crazed city during last year's championship season found that ER caseloads dipped by 15 percent on days with televised, important games -- especially when the Sox were belting home runs and playing well.

ERs got more crowded again, however, during games when a Red Sox loss seemed imminent.

One especially fervent -- and admittedly biased -- fan hailed the study as yet more proof of BoSox glory.

"Clearly, this study demonstrates that the Red Sox winning is good for the health of western civilization," quipped team president and CEO Larry Lucchino.

But the researchers said they're not entirely sure how the team's triumphs helped ease the workloads of local hospitals.

"We didn't look at reasons why people were coming in for care, we just looked at the numbers -- and the numbers dropped during very important games," said study co-author John S. Brownstein of the Informatics Programs at Children's Hospital in Boston.

But he theorized that for an especially exciting game, fans may put mere physical maladies on hold for a while.

"While we can't judge why people are coming to the ER in this case, they are making a decision as to whether or not to seek health care, and they obviously may be thinking: 'No time to go to the ER, we got a serious game on our hands,' " suggested Brownstein.

Reporting in a letter to the editor of the October issue of the Annals of Emergency Medicine, Brownstein's group stressed that the link between important cultural events and a drop in ER visits has been reported elsewhere. But, the researchers said, this is the first time anyone has calculated a statistical connection like the one seen in this study.

In the study, Brownstein and Children's Hospital colleague Ben Y. Reis, along with Dr. Kenneth D. Mandl, of Harvard Medical School, tracked Nielsen TV ratings to determine hourly television viewership throughout the greater Boston area during 2004 post-season Red Sox games.

That year, the Red Sox participated in seven American League championship games against the New York Yankees, and four World Series games against the St. Louis Cardinals. All games -- whether played at Fenway Park or elsewhere-- were included in the final tally.

Using data from a statewide monitoring system, the researchers compared viewership numbers to the ebb and flow of patients seeking health care at any one of six emergency rooms in the greater Boston area while -- but not before or after -- the 11 games were under way. Those numbers were compared to rates for ER visits on similar dates and times during 2002 and 2003.

They found that all six hospital ERs combined averaged 31 patient visits per hour across all 11 playoff games.

Game by game, those with the highest Neilsen ratings were found to be associated with the lowest ER patient visits, while the lowest-rated match-ups were found to be associated with the highest number of incoming patients.

The last games of the American League championship and World Series were the most watched, respectively, as the Red Sox showed off their winning ways. Between 55 percent and 60 percent of Boston-area households tuned in to each of these games, and during those times ER visits dropped about 15 percent below normal volume.

The fifth American League game -- a Red Sox victory coming on the heels of a surprising late-in-the-game comeback in the series' fourth game -- also had strong viewership, and ER attendance during this game dropped to 5 percent below normal, the researchers found.

On the other hand, a Red Sox loss in the third American League game against the Yankees and their near-loss in the fourth game in that series provoked a drop in viewership. During those less-than-stellar Red Sox performances, visits to the ER rose to 15 percent above normal, the researchers reported.

Brownstein stressed that the study was not able to determine whether or not the local rate or nature of injuries fluctuated depending on game popularity.

His team does conclude that Red Sox viewership had an inverse relationship to ER attendance. And the researchers suggested that major televised events of all kinds -- including those that appeal to an audience beyond Red Sox fans -- may influence patient decisions on whether and when to seek emergency health care.

"The Red Sox represent something very unique," noted Brownstein. "There had been a major victory drought, and there was a huge amount of attention directed towards the games, and Red Sox fans are known as being diehard. But past literature has shown that the effect of soccer games, the Super Bowl, and other sporting events have a similar effect on ER visits."

"There's not necessarily something physicians can do about any of this," added Brownstein, "but it does say how health care volume in general can be affected by an external force."

Dr. Wally Ghurabi, director of the emergency department at Santa Monica-UCLA Medical Center in Santa Monica, Calif., expressed no surprise at the Red Sox research.

"This isn't far-fetched at all," he said. "They have documented what all of us in this business have known for a while."

Ghurabi said the findings are a function of the fact that, by his count, 30 percent to 40 percent of visits to the ER are not true emergencies, but rather incidents that could theoretically be easily handled by a family physician. This, he noted, leaves room for a great deal of discretion when it comes to when or if an individual chooses to come to an ER for treatment.

"Almost uniformly, ER rooms in the country have become a safety net," he said, "for working mothers who come after 5 p.m. when the doctor's office is closed, for the uninsured, for the homeless, for those with minor problems who have nowhere else to go."

"So during the (National Basketball Association) Laker championships here in Los Angeles, the ER is empty and you only see very critical patients," said Ghurabi. "And I can attest to the fact that, during the Super Bowl and World Series, people are hooked to the TV. They say to themselves -- and to the people dependant on them for transportation -- 'I'll take you to the ER after the game.' And after the game you get an influx, when it's convenient. It relates to events of all kinds."

More information

For more on handling medical emergencies, check with the American College of Emergency Physicians.

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