68: Primary Care Referral to the Emergency Department as an Indicator for Hospital Admission

Crowding has become an all too familiar occurrence in American emergency departments nationwide. The Institute of Medicine released a report in June 2006 on the state of emergency medical care in the nation, highlighting crowding as one of the greatest threats to quality patient care. Since 1993, the numbers of patients presenting to emergency departments have continued to rise from 90.3 million visits to 113.9 million visits in 2003 (IOM). However, despite this increase, the number of available emergency departments and available treatment beds has continued to drop, precipitating a system-wide crisis. Because of the heightened demand for immediate care, patients often contact their primary care providers hoping to seek urgent, immediate care or guidance, only to be referred to the emergency department.