An Outline
Emergency departments (EDs) are a very important part in the health care safety network. They are available 24 hours a day, 7 days a week, for all who need care. There has been a constant increase in the number and sharpness of patient visits to EDs, now with well over 100 million Americans (30 million children) receiving emergency care yearly. This rise in ED employment has in effect saturated the capacity of EDs and emergency medical services in many communities. The resulting trend, generally referred to as ED overcrowding, now endanger access to emergency services for those who need them the most. As managers of the pediatric medical home and advocates for children and optimal pediatric health care, there is a very important role for pediatricians and the American Academy of Pediatrics in guiding health policy decision-makers toward useful solutions that support the medical home and judicious access to emergency care.
Overcrowded Emergency Rooms: An Introduction
America's hospital emergency rooms are overcrowded with patients who may be better served in doctors' offices or other clinic settings, according to a national study. A great deal has been written about the use of emergency services. A predictive 1958 study studying a considerable increase in emergency department (ED) use advised that physicians and hospitals should plan for the future by increasing the number of emergency facilities. (Shortliffe, 20 –25). Since that time, the number of ED visits in the United States has increased more than 600%. Thirty million of those ED visits were for children 0 to 18 years of age.
Over the past 2 decades, there has been growing apprehension about this remarkable growth in ED visits. During the mid-1980s and early 1990s, many health care policy analysts viewed these upsurge as evidence of over utilization of EDs, particularly for non-emergent problems........
