Emergency Department Capacity and Access in California, 1990-2001

An Economic Analysis

Published in: Health Affairs - Web Exclusive, Mar. 24, 2004, p. W4-136-W4-142

Posted on RAND.org on December 31, 2003

by Glenn Melnick, Amar Nawathe, Anil Bamezai, Lois Green

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Media report that hospitals are closing their emergency departments (EDs) and reducing access to ED services, raising concerns that EDs are not sustainable under competition and managed care. The authors analyzed financial, economic, capacity, and utilization data for California EDs for 1990-2001. The authors found that contrary to media reports, hospitals are not abandoning the ED market. Rather, our results show a robust market, where hospitals are adding ED capacity to meet increased demand and to maintain access. Supporting economic analyses show that EDs are sustainable since they generate a sizable and growing portion of inpatient admissions, which contribute to overall economic viability.

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