Authors of a perspectives piece in the current issue of the New England Journal of Medicine take a look at the evolution of the hospital emergency room (ER) over the last 50 years. They point back to a 1958 study conducted by leaders at Hartford Hospital, Hartford, CT, that found that ER use had increased at most hospitals nearly 400 percent between 1940 and 1955, even in communities with little or no population growth.
Almost half of the respondents attributed this increase in ER vistis to ”the inability of patients to reach physicians on weekends, nights or holidays for either emergency or urgent appointments and the orientation of the public to the hospital as a place where one can receive aid at all times.”
The intervening years have seen many changes in ER operations, staffing patterns, therapeutic modalities, technology, and complexity of care. The authors of the current article characterize the ER as a microcosmic view of the community’s health care system, noting that “the quickest way to assess the strength of a community’s public health, primary care, and hospital systems is to spend a few hours in the emergency department.”
Source: Kellerman, A. L., and Martinez, R. The ER, 50 years on. New England Journal of Medicine. 364(24):2278-2279, June 16, 2011. http://www.nejm.org/doi/full/10.1056/NEJMp1101544
Posted by the Center for Hospital and Healthcare Administration History, (312) 422-2050, rc@aha.org.
