Alternatives For Overcrowding Emergency Departments

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Meeting the Challenge and Filling the Gaps in America’s Healthcare System
Executive Summary: Many visits to the Emergency Department are made for non-emergent needs. This causes congestion in the healthcare system and makes it harder for those who truly need emergent medical attention receive the care they need. Aging populations, under or non-insured patients, Medicaid expansions, and Psychiatric/Behavioral Health problems directly impact overcrowding in the Emergency Department. Providing alternative facilities and services, and utilizing Community Paramedicine programs will alleviate the strain overcrowding Emergency Departments face on a regular basis.
Introduction: Overcrowding in
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Federal Mandates: Annual visits to the Emergency Department in the United States grew by 40% between 1998 and 2013 while the number of hospitals with an Emergency Department available declined by 14% (Newhook, 2014). Emergency Medicine is the only specialty within the “House of Medicine” that carries mandates from the federal government to provide care to anyone who requests it. One such federal mandate is The Emergency Medical Treatment and Active Labor Act (EMTALA). The EMTALA requires hospitals and ambulance services to provide care and treatment to anyone needing or requesting it, regardless of their ability to pay, legal status, and citizenship (Barish, Mcgauly, & Arnold, 2012). A survey conducted by the American Hospital Association (2010) revealed that more than half of America’s urban hospital emergency departments were at or over capacity 130 out of 168 hours in a given week. The surveyed showed non-emergent visits tripled the emergent visits.
Behavioral Health: Instance of Psychiatric/Behavioral Health Problems have significantly increased over the last few decades. While many of the causes are unknown, Behavioral problems negatively impact overcrowding in the emergency department. David Judge (2013) reports Mental Health related ED visits have increased 75% between 2002- 2014. The issues is not the fact there is an
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