IOM: New reports on Emergency Medicine

Following a two-year investigation, the Institute of Medicine (IOM) yesterday issued three reports concluding that “the nation’s emergency medical system…is overburdened, underfunded, and highly fragmented.”

Emergency Care for Children: Growing Pains

Emergency Medical Services At the Crossroads

Hospital-Based Emergency Care: At the Breaking Point

According to the IOM, demand for emergency services has surged over the last several years, rising to 114 million ED visits in 2003 from only 90 million visits in 1993, while the number of inpatient hospital beds declined by 198,000 during the same period as hospitals shifted toward more outpatient care. According to the reports, hospital EDs are currently overwhelmed by day-to-day emergencies, with more than 500,000 ambulances being diverted from overcrowded EDs in 2003. Furthermore, the IOM warns that the nation’s EDs are ill-equipped to handle a sharp influx of patients in the event of a terrorist attack, natural disaster, or pandemic flu.

As a result, the group is urging Congress to establish a pool of $50 million that will be spent to reimburse hospitals for emergency care provided to poor and uninsured patients. The reports also recommend that Congress take steps to ensure that hospitals and emergency medical workers receive a greater portion of the nation’s disaster-preparedness funding. In addition, the IOM calls on JCAHO to develop “strong guidelines” aimed at reducing ambulance diversions and overcrowding in EDs, and an ED physician and panel member adds that in the absence of systemwide reform, individual hospitals can take steps to improve ED efficiency and preparedness.