"One of the most important elements of patient-centered care is deciding when individuals can't be safely managed in community settings," said Dr. Wes Fields, chair of the Emergency Medicine Action Fund, which sponsored the RAND research. "Emergency physicians are trained to rapidly evaluate a wide array of conditions that are complex or time sensitive, and facilitate observation or admission of the most acutely ill patients. The study also suggests that the biggest challenge facing most ERs is trying to meet the needs of the growing population of Medicare age. Whether you live in a big city or a rural area, trying to find the right level of care for seniors with not one but several medical conditions is an ongoing struggle that plays out nights, weekends, and holidays at the front door to the hospital. Emergency departments are as vital as medical homes in every medical community."
Lack of access to follow-up care is a top concern that influences the decision of emergency physicians to admit particularly fragile patients to the hospital, rather than take a chance that they will fall through the cracks and suffer harm.
"The Rand report highlights the lack of follow-up care for many patients who come to the ER," said Dr. Alex Rosenau, president-elect of ACEP. "Sometimes physicians can send people home if they know their patients will be able to get their medications, have support from family or friends and can schedule follow-up medical visits. Sometimes these resources don't exist and we make decisions to admit. Emergency physicians coordinate transitions of care every day in hospitals across the country, filling the gaping holes in our health care system."
The report recommends that hospital administrators, policymakers, payers and federal research agencies reco
|Contact: Julie Lloyd|
American College of Emergency Physicians