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June 19, 1996

Emergency Medicine

Author Affiliations

University of North Carolina, Chapel Hill

JAMA. 1996;275(23):1804-1805. doi:10.1001/jama.1996.03530470032019

Major clinical developments in emergency medicine in 1995 were evaluation of access and use of emergency care, emergency department surveillance and injury prevention, and improvements in pediatric emergency care.

Economic considerations are a major challenge to emergency medicine practitioners and health care consumers. Research in emergency medicine is diversifying so that objective data can be generated to analyze problems with emergency care access and delivery and to evaluate and reduce costs. Estimates that 43% of emergency department visits are "unnecessary"1 have been challenged on numerous fronts, including limitations of access to primary care, lack of a standardized medical definition of "emergency," and inability of patients to identify a medical emergency. Criteria for "appropriate" emergency department use generally do not consider the patient's chief complaint. In his review of 1190 consecutive ambulatory patients presenting to an urban public hospital emergency department, Baker et al2 found that 89% of patients