Overcrowding in the nation's emergency departments: Complex causes and disturbing effects

Ten years ago, serious overcrowding in emergency departments became a natio nal issue. Although temporary improvement of the problem occurred, the issu e of ED overcrowding has now resurfaced and threatens to become worse. Over crowding is caused by a complex web of interrelated issues described in thi s article. ED overcrowding has multiple effects, including placing the pati ent at risk for poor outcome, prolonged pain and suffering of some patients , long patient waits, patient dissatisfaction, ambulance diversions in some cities, decreased physician productivity, increased frustration among medi cal staff, and violence. Solving the problem of overcrowding will not only require a major financial commitment from the federal government and local hospitals, but will also require a cooperation from managed care. Unless th e problem is solved in the near future, the general public may no longer be able to rely on EDs for quality and timely emergency care, placing the peo ple of this country at risk.