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A short stop in ER visits

With Sox fans afflicted by playoff fever, hospital traffic dropped off, study shows

There is one epidemic, it turns out, that could actually provide a cure for Boston's terminally teeming emergency rooms: Red Sox fever.

A couple of dyed-in-the-red-wool Fenway fanatics -- who, by day, specialize in analyzing trends in health-care use -- wondered what happens to emergency room traffic when the Sox catapult into the playoffs.

The result of their research: Last fall, while the Sox pummelled the Yankees in the deciding game of the league championship and, then, the Cardinals in Game Four of the World Series, business in the ER was as cold as Manny Ramirez's bat was hot.

''We knew if we were looking for any public event that would have an effect on health-care utilization, it would have to be the Red Sox championship games," said Ben Reis, inveterate Sox fan and Children's Hospital Boston researcher.

So Reis and his colleague John Brownstein (''John came from Montreal," Reis said, ''but he quickly converted to Red Sox Nation.") used a sophisticated ER surveillance system to track patient visits last fall at half-a-dozen hospitals in metropolitan Boston.

Then, they compared that with television ratings for red-hot Sox games during the team's now-legendary run toward the World Championship.

''Fenway Park is sold out every night, so we couldn't use attendance as a measure," Brownstein said. ''But enthusiasm for a game can be measured with the Nielsen TV ratings."

The researchers discovered that during the championship games, televisions were blaring in three of every five households in the Boston area, watching Curt, Johnny, and the rest of the self-proclaimed Idiots.

At the same time, visits to the emergency rooms plummeted, on average, by 15 percent when compared to historical trends for ER visits on autumn evenings.

One of those hospitals was Beth Israel Deaconess Medical Center, where Dr. Jonathan Edlow is vice chairman of emergency medicine.

''I've always noted that when there's a big game, especially a hometown big game, it gets slow in the ER," said Edlow, who first observed the phenomenon in the 1980s at Mount Auburn Hospital in Cambridge, when the Celtics dominated the NBA.

And it's not just sports: Dr. Alasdair Conn, the ER chief at Massachusetts General Hospital, said that on Sept. 11, 2001, and during similar moments of major national tumult, the emergency department turns quiet.

''I have no idea where the patients go, but they don't come to the emergency room," said Conn, whose hospital was included in the study. ''It's as if when they look at TV and see what's happening, they say, 'My infected lung, it's not so bad.' ''

The ER doctors, as well as the authors of the study that appears in today's Annals of Emergency Medicine, said they suspect that when the Sox are in the throes of the playoffs, patients who can defer an ER visit do.

''The heart attacks, the strokes, they will come no matter what's going on," Conn said. ''The patient with pneumonia, the patient with an asthma attack will say, 'Maybe I can ride this out at home.' "

The decline in visits -- and the assumption that the patients who deferred care were those whose conditions were not true emergencies -- illustrates a long-recognized reality in emergency medicine: For many patients, especially those without insurance, the ER is where they go for basic medical services.

There was no evidence, the researchers from Children's report, of a surge in ER visits immediately after the game concluded. ''It wasn't like people were holding off until the ninth inning and then running to the emergency department," Brownstein said.

As the Sox find themselves locked yet again in a battle with the Yankees for supremacy of the American League East, Brownstein and Reis are considering another research project.

They know long-suffering Sox fans will delay their ER visits, but what about partisans of that team from the Bronx?

''We'd expect," Brownstein sniffed, ''not to see this effect in New York City."

Stephen Smith can be reached at stsmith@globe.com.

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