Another Look at Emergency Room Overcrowding: Accessibility of the Health Services and Quality of Care

Abstract

To understand why some achievable benefits are not achieved it is necessary to evaluate the varying performance of health services according to the social origin of the users.

Can the Emergency Department Algorithm Detect Changes in Access to Care?

“…This same toolkit includes a methodology developed by Billings and colleagues for studying emergency department (ED) visits as a measure of access to care 13–15 . ED utilization rates vary by insurance status, socioeconomic status, race, and other economic and social factors, 16–25 confirming the clinical experience of many emergency physicians (EPs)—that patients often use the ED as a safety net for lack of access to care elsewhere. A common perception is that patients with poor access to care often use the ED for “nonurgent” or “inappropriate” problems that could be treated in less expensive outpatient settings.…”

Comparison of the National Emergency Department Overcrowding Scale and the Emergency Department Work Index for Quantifying Emergency Department Crowding

“…The patient's length of stay increases, thus increasing the number of patients who leave the ED without being seen, 12-15 some of whom may have diseases that are as much of a significant medical emergency as those of patients who stay to be seen. 12,13,[15][16][17][18][19][20][21] Among those who stay to be seen, ED overcrowding affects quality of care [22][23][24][25] and patient satisfaction. [26][27][28][29][30][31] Inadequate patient care leads to medical errors as an ED becomes more overcrowded.…”

La carga de la enfermedad por rotavirus en niños menores de cinco años, Colombia, 2004

“…A pesar de los avances logrados en Colombia en los últimos años, la diarrea en menores de 5 años sigue siendo un problema importante de salud pública. En la morbilidad por diarrea influyen la pobreza, la edad de los niños, la falta de afiliación a la seguridad social de salud, la desnutrición, la lactancia materna inadecuada, la deficiencia en el acceso y la calidad de la atención de los servicios de salud, entre otros factores de riesgo que se pueden mejorar con programas eficaces como el de Atención Integrada de las Enfermedades Prevalentes de la Infancia (AIEPI) y el programa contra la enfermedad diarreica aguda (30,(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49).…”