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PROFESSION

IOM panel seeks lead federal agency on emergency care

It also recommends a five-year demonstration project to help states better coordinate emergency care. Physicians hope the report leads to action.

By Kevin B. O'Reilly, amednews staff. July 10, 2006.

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An exhaustive, 900-page series of Institute of Medicine reports released in June has confirmed what physicians have complained about for years: Emergency departments are overcrowded, underfunded, short of on-call specialists, poorly equipped for pediatric care, and woefully unprepared to handle the surge in patients that a major terrorist attack, disease outbreak or natural disaster would bring.

Emergency physicians hailed the findings.

"It's an external organization that has looked at my world and validated what we've been saying about emergency medicine for years," said Frederick C. Blum, MD, president of the American College of Emergency Physicians. "We sometimes get the sense that nobody's listening to us."

A. Brent Eastman, MD, chief medical officer of Scripps Health in San Diego and a member of the 40-expert IOM panel that released the reports, said there is a crisis in emergency care and that the reports are a "crucial first step in addressing this crisis."

The reports, which focus separately on hospital-based emergency care, pediatric emergency care and emergency medical services, were prepared over two years at a cost of $3 million and recommend:

  • Creating a lead federal agency within Health and Human Services to consolidate functions related to emergency care that are scattered across multiple agencies.
  • Appropriating $50 million for hospitals that provide large amounts of uncompensated care.
  • Enacting an $88 million demonstration program over five years to encourage states to create a more coordinated, regionalized and accountable emergency care system.
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