The sagging safety net. Emergency departments on the brink of crisis.

U.S. hospitals are facing an emergency care crisis. At the same time emergency departments are overflowing with uninsured patients seeking primary care, violence-related trauma cases are soaring, leaving underfunded trauma systems on the verge of collapse. In a special cover package, we explore the causes of the crisis, the current prospects for change, and related issues in emergency care today. Beginning on page 26, we present an overview of the crisis, with particular attention to the breakdown of trauma systems. Starting on page 30, we look at the growing threat of violence itself entering hospital EDs; on pages 34-35, we examine how hospitals are attracting and retaining critically needed clinicians, and how trauma systems are dealing with ongoing shortages of specialists. On pages 37-38, we explore the patient satisfaction question; and on pages 38-39, we present the latest data on emergency care utilization from the American Hospital Association.