America's health care safety net: Intact or unraveling?

In virtually every community in this nation, the emergency department (ED) is an integral part of the health care safety net, often serving as the onl y available point of access to the health care system for many vulnerable a nd disenfranchised individuals. The authors present a brief overview of the March 2000 report released by the Institute of Medicine that described and assessed the current status of the nation's health care safety net. The au thors discuss the role of the ED as a safety net provider and as a window o nto the status of the rest of the health care system. The authors describe the Andersen behavioral model of health services use and suggest it as a us eful theoretical framework for emergency medicine researchers who are inter ested in studying these issues.