Emergency medicine (EM) is a fast-paced, team-oriented specialty specializing in acute care of patients who present without prior appointment, either by their own means or by ambulance. Here patients are seen in order of the urgency of their condition. According to the American College of Emergency Physicians (ACEP), since the implementation of the Affordable Care Act, there is a rise in emergency visits. In an online poll conducted by ACEP, 86 percent expect emergency visits to increase over the next three years.
A recent report from the researchers of the University of Michigan in the journal Annals of Emergency Medicine finds that busy emergency departments, when compared with the least busy are offering a better chance of survival especially to patients whose condition is life-threatening.
Data on patients who had sought emergency care between 2005 and 2009 were analyzed. The data from the study covered 17.5 million patients attending nearly 3,000 hospitals across the US that was taken from the Nationwide Inpatient Sample database compiled by the Agency for Healthcare Research and Quality. The data did not include patients transferred to another hospital or emergency department, those admitted to observation units, and those attending hospitals that saw fewer than 1,000 emergency patients in a year. Deaths occurring during the first 2 days of hospitalization and during the whole stay were also analyzed.
It was found that overall, emergency patients had a 10% lower chance of dying if they went to one of the busiest EDs than if they went to one of the least busy, even for life threatening conditions. The reason for this, according to the study, may be practice. The higher the number of patients a center treats, the better experienced emergency physicians become in handling such cases. While the risk of dying with sepsis was 26% lower, for patients with lung failure the chance of dying was 22% lower.
The report concluded that if all emergency patients received the kind of treatment delivered by the busiest EDs, 24,000 fewer patients would die each year. However further research is required to understand why the differences in survival occur.