Articles: emergency-services.
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Many factors threaten the hospital emergency department. Socioeconomic and healthcare trends are forcing facilities to eliminate some services. Society's failure to deal with these issues portend disaster for high-quality care and for timely access to emergency care. ⋯ The emergency department has an impact on the facility's bottom line. The emergency department can positively affect this by ensuring accurate billing, analyzing fee schedules, and requesting payment at the time service is provided. Other survival issues include developing strategies to retain staff, develop management, negotiate managed care, and reassess the department's design.
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Past studies have shown in many instances that elderly people are represented in the hospital emergency room in proportion to their distribution in the population. It is possible, though, that elderly patients in the emergency room are using different types of resources than individuals of a younger age. Samples of two hospital emergency room users were selected in 1981 and in 1986. ⋯ Age had an effect on use of resources under both conditions, regardless of the patients' gender, time of the visits, availability of alternative sources of emergency care, and diagnostic categories. The role of the hospital emergency room is to address medical care needs of specific segments of the population in special circumstances. Elderly emergency room patients are indeed one of these specific segments with very special needs.