The non-profit California HealthCare Foundation has issued three new reports addressing the impact of overcrowding in California's emergency rooms.
The reports come in the wake of an April 2009 report by the U.S. Government Accounting Office that indicated emergency department overcrowding is a significant problem throughout the United States.
The USC Center for Health Financing, Policy and Management wrote a report for CHCF that asks whether California's hospital-based ED system is eroding. The brief by Glenn Melnick of the USC Center analyzes trends in the use and size of California's hospital-based EDs.
Melnick’s report finds that the higher severity of patients seen – more than the growing number of patients – may be contributing to overcrowding. The report includes an analysis of ED capacity growth and demand in the state's 10 largest counties.
A second report, by The Abaris Group, based in Walnut Creek, Calif., assesses the scale and impact of ED diversion in California and the United States. The report reveals that ambulance diversion has not only been shown to be ineffective at reducing overcrowding, it can have negative effects on patient safety, continuity of care and the operation of surrounding hospitals.
Titled "Reducing Ambulance Diversion in California: Strategies and Best Practices," the report also summarizes the work of the recently completed California ED Diversion Project, a CHCF-funded initiative.
The final report, also by The Abaris Group, assesses the growth of free-standing emergency departments (FEDs) in the United States. Although no strict definition exists, FEDs provide emergency care but are physically separated from an acute care hospital.
The report finds that FEDs have the potential to provide greater patient access in communities that do not have a hospital emergency service. It also reviews current federal and state regulation and discusses the prospects for the spread of FEDs in California.