Safety net hospital emergency departments: creating safety valves for non-urgent care.

Laurie E Felland, Robert E Hurley, Nicole M Kemper
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Abstract

Hospital emergency departments (EDs) are caring for more patients, including those with non-urgent needs that could be treated in alternative, more cost-effective settings, such as a clinic or physician's office. According to findings from the Center for Studying Health System Change's 2007 site visits to 12 nationally representative metropolitan communities, many emergency departments at safety net hospitals--the public and not-for-profit hospitals that serve large proportions of low-income, uninsured and Medicaid patients--are attempting to meet patients' non-urgent needs more efficiently. Safety net EDs are working to redirect non-urgent patients to their hospitals' outpatient clinics or to community health centers and clinics, with varied results. Efforts to develop additional primary, specialty and dental care in community settings, along with promoting the use of these providers, could stem the use of emergency departments for non-urgent care, while increasing access to care, enhancing quality and containing costs.

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安全网医院急诊科:为非紧急护理创造安全阀。
医院急诊科(EDs)正在照顾更多的病人,包括那些有非紧急需求的病人,这些病人可以在诊所或医生办公室等其他更具成本效益的环境中接受治疗。根据卫生系统改革研究中心2007年对12个具有全国代表性的大都市社区的实地考察的结果,许多安全网医院的急诊部门——为大量低收入、无保险和医疗补助患者提供服务的公立和非营利医院——正试图更有效地满足患者的非紧急需求。安全网急诊科正在努力将非紧急病人转到他们医院的门诊诊所或社区卫生中心和诊所,取得了不同的结果。努力在社区环境中发展更多的初级保健、专科保健和牙科保健,同时促进利用这些提供者,可以阻止利用急诊科进行非紧急护理,同时增加获得保健的机会,提高质量并控制费用。
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