Access to Emergency Medical Care

Abstract

More than 60 000 children seek emergency care each day in the United States. However, inequities in our present health care system often preclude the prompt and appropriate access to emergency care necessary to treat these infants, children, and young adolescents—hereafter referred to as children. Several important obstacles exist. (1) As of 1990, there were more than 12 million uninsured American children.1 (2) Many children are declared uninsurable because of chronic illnesses, disabling conditions, or other preexisting conditions. (3) Although emergency departments are required to evaluate all patients who seek care, it is well known that lack of insurance can serve as an obstacle to prompt access to, transport to, and treatment at appropriate-level emergency and critical care facilities. (4) There is not yet universal availability and appropriate use of the 911 access number.2 (5) The extent to which pediatrics is included in the educational and training content of paramedic and basic emergency medical technician programs has been shown to be less than adequate.3,4 (6) Finally, children have special needs, requiring services not always available in every hospital. Therefore, the obstacles to prompt access are magnified at a critical time for the child seeking emergency care. Several recent developments have increased the recognition and understanding of the unique emergency medical care needs of children.