State of affairs of emergency medicine in the Veterans Health Administration.

Overview

BACKGROUND: The Veterans Health Administration (VHA) has reformed its emergency medical services. OBJECTIVES: This study updates an overview of emergency medicine within VHA. METHODS: This is a cross-sectional survey of VHA medical facilities offering emergency medical care. RESULTS: Sixty-eight percent (95/140) of facilities had emergency departments (EDs) only, 12% (16/140) had both ED and urgent care centers (UCCs), and 16% (23/140) had only UCCs. The mean (SD) ED/UCC census was 13 371 (7664). A mean (SD) of 53% (27%) of facility admissions were admitted through ED/UCCs. The median of all ED/UCC admissions admitted to intensive care unit level care was 11% (interquartile range, 7-16). Of physicians with any board certification, 16% (209/1331) of physicians had emergency medicine board certification. CONCLUSIONS: Emergency medical care is now available at most VHA facilities. The specialty of emergency medicine has an important but minority presence within clinical emergency medical care at VHA.