HOSPITAL EMERGENCY DEPARTMENTS IN CRISIS:
This research examines the crisis affecting the delivery of emergency health care services in the United States in the 1990s. The current status of the health care system and its effects on emergency care is examined, and the probable effects of health care reform on emergency health care are considered.
In the United States in 1994, health care insurance is unattainable for some people and unaffordable for millions of others (Weil, 1994, pp. 5 15). The same factors that cause health care insurance to be either unattainable or unaffordable also results in delays for the people affected in seeking necessary health care services (Lee, 1993, p. 2784). A typical outcome for such people is that they finally seek emergency medical care when their health conditions have degenerated to the point where such conditions can no longer be ignored.
The important outcomes of the combination of delaying needed health care services and then obtaining those services through a hospital emergency department relate to patient health, health care costs, and the efficient functioning of emergency care departments. First, the health of individuals exhibiting such behaviors is compromised (Franks, Clancy, Gold, and Nutting, 1993, pp. 1295 1299). Second, the costs for the health care services provided are far higher than they otherwise would have been (Lee, 1993, p. 2784). Third, hospital emergency departments are overwhelmed with a consequent deterioration in the quality of care delivered (Rubin, Gandek, and Rogers, 1993, pp. 835 840). Any one of these outcomes supports the consideration of health care reform. The combined effects of these outcomes demands health care reform.
As costs associated with the delivery of health care services soared in the 1980s, third party funders, health care providers, and users of health care services sought to develop and implement procedures and programs that ...