Are there more small EDs than we thought?
Conventional wisdom among emergency medicine professionals is that the various sizes of the EDs in the United States, when placed in a bar chart, would look like a bell-shaped curve; that is, the greatest number of EDs would be found among the mid-sized EDs, or those with 25,000-30,000 visits per year.
But that’s not the case at all, according to preliminary statistics from the National Emergency Department Inventory (NEDI). The NEDI is a project of Boston-based Emergency Medicine Network (EMNet), which includes ED managers from 185 facilities across the country.
"The median number of annual visits is 15,000, and there are a whole lot of EDs with fewer than 10,000 visits," notes Carlos A. Camargo, MD, DrPH, director of the EMNet Coordinating Center. "Yet all the visits add up to 102 million, which is right where should be according to NHAMCS [the National Hospital Ambulatory Medical Care Survey from the Centers for Disease Control and Prevention]."
The NEDI, drawn from 2001 data, covers a total of 4,862 EDs, a median of 15,711 visits, and a total of 101,555,199 visits. The data were integrated from three sources: SMG Marketing (now Verispan) Hospital Market Profiling Solution Database; the American Hospital Association’s Annual Survey of Hospitals; and surveys performed by EMNet staff.
"This graph raises a lot of issues about the staffing of smaller EDs, and how best to do it," says Camargo. "Is it realistic, for example, to expect a 10,000-visit ED to attract board-certified ED docs?"
ED managers will be interested in details about their peers and where they sit in the rankings, Camargo asserts. "We use this global word, ED,’ but it means different things to different people," he says. "One may have a neurosurgeon, while another has a triage nurse who pages docs to come in."
This project is an attempt to catalogue every ED in the United States to try to determine how they are staffed and how they differ from one another, Camargo says. "Ultimately, this could lead to [benchmarking] comparisons within comparable EDs," he suggests. (To access the NEDI information, go to www.emnet-usa.org and click on "National Emergency Department Inventory." On the map below, you can click on an individual state and see a graph of the EDs. For the national graph, click on "For 2001 national ED statistics.")
Source
For more information on ED statistics, contact:
- Carlos A. Camargo, MD, DrPH, Director, EMNet Coordinating Center, Massachusetts General Hospital, 326 Cambridge St., Suite 410, Boston, MA 02114. Phone: (617) 726-5276. Fax: (617) 724-4050. E-mail: [email protected].
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