Health Affairs

Posting date: March 24, 2004

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Health Affairs, 10.1377/hlthaff.w4.136
Copyright © 2004 by Project HOPE

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Emergency Department Capacity And Access In California, 1990-2001: An Economic Analysis

Glenn A. Melnick ^1*, Amar C. Nawathe ², Anil Bamezai ³, Lois Green ⁴

¹ Glenn Melnick is a professor in the School of Policy, Planning, and Development, University of Southern California (USC), and is a resident consultant at RAND in Santa Monica.
² Amar Nawathe is a resident consultant at RAND and a research associate in the School of Policy, Planning, and Development.
³ Anil Bamezai is a resident consultant at RAND.
⁴ Lois Green is a consultant at USC.

^*Corresponding author.

Abstract

Media report that hospitals are closing their emergency departments (EDs) and reducing access to ED services, raising concerns that EDs are not sustainable under competition and managed care. We analyzed financial, economic, capacity, and utilization data for California EDs for 1990-2001. We found that contrary to media reports, hospitals are not abandoning the ED market. Rather, our results show a robust market, where hospitals are adding ED capacity to meet increased demand and to maintain access. Supporting economic analyses show that EDs are sustainable since they generate a sizable and growing portion of inpatient admissions, which contribute to overall economic viability.

Key Words: Access To Care, Business Of Care, Consumer Issues, Hospitals, Safety-Net Systems, State/Local Issues

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