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...the problem, players across the healthcare spectrum are working on piecemeal solutions, including enhanced triage, alternative care sites and access to primary care and disease management.
The problem facing today's EDs is one of simple supply and demand. On the supply side, the United States experienced a loss of 425 hospitals with emergency departments between 1993 and 2003, according to the Institute of Medicine's three-volume Future of Emergency Care report. That represented a 9% decrease in the number of EDs serving the population. At the same time, hospital closures reduced inpatient capacity by about 198,000 beds. This sharp decline in capacity was largely in response to cost-cutting measures, lower reimbursements by payers, shorter lengths of stay and reduced admissions under evolving care models.
During the same period, the population of the United States grew by 12%. As the population aged and more people were diagnosed with chronic conditions, hospital admissions increased by 13%. Visits to the ED spiked as well: Between 1993 and 2003, ED visits increased 26%. Today roughly 115 million patients access an ED annually and, often because of delaying care, they're sicker and require more treatment.
Not surprisingly, that means an increasing number of patients require admission to the hospital. Nationwide, about 13.9% of ED patients were admitted to the hospital in 2003, according to the IOM report. That represents about 43% of all hospital patients.
ADMISSION BOTTLENECK
Unfortunately, the transition from the ED to a unit is often not...
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