• A Bellou, J-D de Korwin, J Bouget, F Carpentier, V Ledoray, J Kopferschmitt, H Lambert, and Commission d'évaluation de la Société francophone de médecine d'urgence.
• Service d'accueil des urgences, hôpital Central, CHU Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy cedex, France. abdel.bellou@voila.fr
• Rev Med Interne. 2003 Sep 1; 24 (9): 602-12.

PurposeEmergency departments become a useful way to access to hospital care. Since these last years difficulties of hospitalization, mainly of the elderly, after visit to the emergency department, are on the increase.Current Knowledge And Key PointsEmergency departments are an important mode of recruitment for hospital units, 4 patients to 10 are hospitalized from emergency departments. The difficulties of hospitalization starting at the emergency department are more important for the elderly. Actually, there are 2 type of hospital care, planed and non planed care. The development of observation units specific to the emergency departments allowed to resolve some of these difficulties. But they are limited by their small number of beds and the duration of hospitalization below to 36 h. Some hospitals developed polyvalent emergency short stay unit to hospitalize patients who visited emergency department without necessity to give them a specialized care.Future Prospects And ProjectsThis situation must allow us to purpose a better regulation of hospitalizations which includes emergency departments in a network system including the different hospital ways of taking care. A downstream way of care adapted to the emergency hospitalizations would be developed. This could include the emergency department, the observation unit and the emergency short stay unit in interface with internal medicine and general medicine units, geriatric unit and specialized units, all of them will be included in a town-hospital care network.

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