Emergency Departments in the Health Care System: Use of Services in California Counties

Publication Date: March 2003

Publisher: California HealthCare Foundation

Author(s): Policy and Management University of Southern California. Center for Health Financing

Research Area: Health

Type: Brief

Coverage: California

Abstract:

This issue brief explores factors such as population trends, acuity, and lack of insurance to understand the influences on emergency department (ED) capacity and demand in specific counties. The findings of this study reveal wide variation among counties in ED system capacity and the ability to keep pace with a growing population. In each of the seven counties studied, however, the data suggest that ED systems were evolving to meet demand by adding to the supply of ED beds. The counties studied are Contra Costa, Los Angeles, Sacramento, San Diego, San Francisco, San Luis Obispo, and Santa Clara. This issue brief also analyzes key indicators that may point to potential capacity constraints but notes that underlying factors, such as the interplay of each county's ED system with that of neighboring communities, must also be taken into account. The county-level analysis vividly demonstrates the dynamic and complex nature of the ED system in California's system shaped not only by its geography and demographics, but also by an evolving network of physician, hospital, and emergency resources and capabilities. Because of the varying county situations, the issue brief notes that one-size-fits-all solutions may do more harm than good.