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Emergency Services

The emergency department can be seen as both the first and the last resort for patients. For patients with time-sensitive and critical conditions such as myocardial infarction, stroke, asthma, and sepsis, the emergency department is the first and most appropriate place in the health care system to seek treatment. For other patients who may not require emergent or critical care, however, the emergency department, too, serves as the last resort. As the only place in the entire United States' health care system where all patients are seen regardless of their ability to pay, the emergency department therefore serves as a critical piece of the safety net.

Listed below are publications and projects that CHCF's Market & Policy Monitor Program has contributed in the area of emergency services.

Physicians on Call: California's Patchwork Approach to Emergency Department Coverage

February 2011

The state's system for securing on-call emergency department specialist coverage remains costly, complex, and on the edge due to payment concerns, liability questions, and a shortage of specialists.

Many Emergency Department Visits Could Be Managed at Urgent Care Centers and Retail Clinics

September 2010

This Health Affairs article by Weinick, Burns, and Mehrotra finds that up to 27% of hospital ED visits are not emergencies and could take place at less expensive urgent care centers and retail clinics.

California Hospital Facts and Figures

April 2010

California's 512 acute care hospitals cared for 3 million inpatients and 42 million outpatients in 2007. This report examines these hospitals in terms of their bed supply and capacity, geographic distribution, ownership type, utilization, and financial health.

Is California's Hospital-Based ED System Eroding?

July 2009

Although there are fewer emergency departments (EDs) in California hospitals, some hospitals have expanded their EDs. This issue brief analyzes trends in the use and capacity of the state's hospital-based EDs.

Facts and Findings for Policymakers: Hospital Seismic Safety

January 2009

Meeting upcoming earthquake safety deadlines may be problematic for as much as half of California's at-risk health care infrastructure. Background and options are discussed in this publication, the first in a series for policymakers.

Adoption of Patient Tracking Systems among Hospital Emergency Rooms in California

July 2008

This issue brief presents the results of a survey that finds that most California hospitals are using emergency department tracking systems, but with varying levels of satisfaction and success.

Worry and Neglect: Californians Respond to the Rising Cost of Care

July 2008

This snapshot suggests that increasingly, Californians are trying to control medical costs by neglecting care and asking for cheaper medications, leading to more hospitalizations and emergency department use.

Seismic Safety: Will California Hospitals Be Ready for the Next Big Quake?

January 2007

This report by RAND, a follow-up to a 2002 study, examines the progress California hospitals have made, and the challenges they face, in meeting seismic safety deadlines established under SB 1953.

Overuse of Emergency Departments Among Insured Californians

October 2006

This report examines the factors leading to inappropriate emergency department use by insured patients in California and recommends strategies to increase alternatives to ED use.

On-Call Physicians at California Emergency Departments: Problems and Potential Solutions

January 2005

This issue brief examines why California's on-call physician system is unstable, how emergency departments are coping, and possible strategies for improving on-call coverage.