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Areawide Planning for Emergency Services

Robert M. Sigmond
JAMA. 1967;200(4):308-312. doi:10.1001/jama.1967.03120170080015.
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For areawide health planning to be effective, the distinction between emergency and non-emergency services must be recognized. At the same time, it is important that the significant interrelationships of these services be considered in initial planning.

It might appear that areawide planning simply involves estimation of the relative volume of care requiring emergency and non-emergency treatment, with an allocation of resources and a configuration of services reflecting the estimated needs. Unfortunately, such planning is more complex. Current patient volume in emergency facilities already exceeds estimates of the need for "true" emergency care, as defined by physicians, and the volume is rising. Continued adaptation of emergency departments to the increasing demand will result in their gradual conversion into ever larger impersonal health supermarkets—into second-rate health centers, ill-adapted for either emergency services or general ambulatory care.

Certain adjustments in the total system of providing health services could lead to a reduction in


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