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Is There A Crisis in Emergency Medicine?

Q. Is there a crisis in the nation’s emergency departments?

A. Yes. Emergency department visits in 2003 rose to 114 million, up from 89.8 million in 1992. At the same time, the number of emergency departments decreased by 15 percent, resulting in dramatic increases in patient volumes and waiting times at the remaining facilities.

Q. What is the impact of overcrowding on patient care?

A. According to the U.S. General Accounting Office, overcrowding causes prolonged pain and suffering for patients, long emergency department waits, and increased transport times for ambulance patients.

Q. What is causing the crisis?

A. A lack of hospital inpatient beds; a shortage of on-call medical specialists; an increasing elderly population; and nationwide shortages of nurses, physicians, and support staff.

Q. Why do hospitals "board" inpatients in the emergency department?

A. Hospitals are not always able to meet the demand for inpatient beds for emergency patients because of financial pressures. This can lead to waits of hours or days for an available inpatient bed

Q. What are the solutions?

A. the United States must make a national commitment and recognize that emergency medicine is an essential community service that must be funded.

Q. Can the problem be solved by educating people not to use the emergency department for minor medical problems?

A. No. Most patients who seek hospital emergency care are very sick or would be by the time they could see a primary care doctor. Only 10 percent of emergency department visits in 2002 were classified as non-urgent.

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