2013 marks the 30th anniversary of the founding of the first
emergency department(ED) in China. Since its naissance in 1983 in Peking
Union Medical College Hospital, after continuous enrichment and
development, ED has been a relatively young and burgeoning department and
now playing an ever more significant role in China's hospitals. Meanwhile,
emergency medicine (EM) has emerged as a trans-specialty discipline and
tremendous progress has been made in EM research and published research
articles have been increasing in number in recent years[1].
Nonetheless, considering the over-crowded emergency room and the
dramatically increasing demand for emergency rescue services in China, the
status of EM still lags behind request and is yet now far from
satisfaction. Traditionally, the ED has been considered as the buffer of
hospital overflow, with the inability to transfer admitted patients to
inpatient beds due to high hospital occupancy ranking as the most
important reason. Moreover, the unwillingness of giving prominence to ED
priority, the unharmonious collaboration between ED and in-patient wards
and the tendency to admit patients without multi-organ complications all
contribute to the deterioration of ED over-crowding. Meanwhile, the aging
society with increasing occurrence of chronic diseases has put further
strain on the length of ED stay, which increases the high risk for serious
complications[2]. Besides, the emergency response system and hospital
preparedness for public health emergency are at early stage of development
and still need to be improved and optimized. The SARS crisis in 2003, the
5.12 earthquake in 2008 and the rainstorm, which resulted in 77 deaths
last year in Beijing, have exposed the loopholes of the authorities'
emergency management and still deserve our reflection.
China's healthcare reforms have been an important part of the
country's efforts to provide more social security and improve people's
well-beings. We hail the government's endeavor to boom healthcare
expenditure[3]. But more could be done. Firstly, the uneven distribution
of medical resources needs to be revised and more grassroots hospitals and
more investments from private healthcare providers are welcomed so that
patients with chronic diseases can receive timely treatment locally
instead of squeezing in the observation unit. Secondly, the efficiency of
transferring ED boarders to in-patients beds and the cooperation between
ED and inpatient wards need to be improved. Last but not least, in order
to reduce mortality, great emphasis should be placed on construction of a
more systematic and sound emergency response system.
Competing interest: None.
References
1 Cui H, Gao QQ, Gao LL. Scientific publication in emergency medicine
from mainland China, Hong Kong and Taiwan: a 10 year survey of the
literature. Am J Emerg Med 2013; doi: 10.1016/j.ajem.2013.01.032.
2 Zhou JC, Pan KH, Zhou DY, et al. High hospital occupancy is
associated with increased risk for patients boarding in the emergency
department. Am J Med 2012; 125(4): 416.e1-7.
3 Xin Hua News. Chinese pay less health expenditure. China Daily
September 17, 2012.http://www.chinadaily.com.cn/china/2012-
09/17/content_15763827.htm (accessed April 10, 2013)
Conflict of Interest:
None declared
2013 marks the 30th anniversary of the founding of the first emergency department(ED) in China. Since its naissance in 1983 in Peking Union Medical College Hospital, after continuous enrichment and development, ED has been a relatively young and burgeoning department and now playing an ever more significant role in China's hospitals. Meanwhile, emergency medicine (EM) has emerged as a trans-specialty discipline and tremendous progress has been made in EM research and published research articles have been increasing in number in recent years[1].
Nonetheless, considering the over-crowded emergency room and the dramatically increasing demand for emergency rescue services in China, the status of EM still lags behind request and is yet now far from satisfaction. Traditionally, the ED has been considered as the buffer of hospital overflow, with the inability to transfer admitted patients to inpatient beds due to high hospital occupancy ranking as the most important reason. Moreover, the unwillingness of giving prominence to ED priority, the unharmonious collaboration between ED and in-patient wards and the tendency to admit patients without multi-organ complications all contribute to the deterioration of ED over-crowding. Meanwhile, the aging society with increasing occurrence of chronic diseases has put further strain on the length of ED stay, which increases the high risk for serious complications[2]. Besides, the emergency response system and hospital preparedness for public health emergency are at early stage of development and still need to be improved and optimized. The SARS crisis in 2003, the 5.12 earthquake in 2008 and the rainstorm, which resulted in 77 deaths last year in Beijing, have exposed the loopholes of the authorities' emergency management and still deserve our reflection.
China's healthcare reforms have been an important part of the country's efforts to provide more social security and improve people's well-beings. We hail the government's endeavor to boom healthcare expenditure[3]. But more could be done. Firstly, the uneven distribution of medical resources needs to be revised and more grassroots hospitals and more investments from private healthcare providers are welcomed so that patients with chronic diseases can receive timely treatment locally instead of squeezing in the observation unit. Secondly, the efficiency of transferring ED boarders to in-patients beds and the cooperation between ED and inpatient wards need to be improved. Last but not least, in order to reduce mortality, great emphasis should be placed on construction of a more systematic and sound emergency response system.
Competing interest: None.
References
1 Cui H, Gao QQ, Gao LL. Scientific publication in emergency medicine from mainland China, Hong Kong and Taiwan: a 10 year survey of the literature. Am J Emerg Med 2013; doi: 10.1016/j.ajem.2013.01.032.
2 Zhou JC, Pan KH, Zhou DY, et al. High hospital occupancy is associated with increased risk for patients boarding in the emergency department. Am J Med 2012; 125(4): 416.e1-7.
3 Xin Hua News. Chinese pay less health expenditure. China Daily September 17, 2012.http://www.chinadaily.com.cn/china/2012- 09/17/content_15763827.htm (accessed April 10, 2013)
Conflict of Interest:
None declared