ICES | Emergency Department Services in Ontario 1993 - 2000 - page 24

Exhibit 14: Summary of Findings and Policy Implications
Institute for Clinical Evaluative Sciences
Emergency Department Services in Ontario
Key Facts
About one in five people in Ontario visit an ED at least
once a year, making it a common portal through which
Ontarians contact their health care system.
The per capita use of EDs by Ontarians has declined
over the past decade. Part of this decline may be
related to fewer low-acuity cases being seen in the ED.
The peak periods in ED volume are predictable and
occur during public holidays, weekends and the
The elderly use more ED services per capita than
younger individuals and their rate of use is rising.
The number of doctors working in EDs has declined
dramatically over the past decade. Those who still
work in EDs have heavier workloads than before and
have more specialized training.
Related Policy Issues or Questions
How can ED volumes be more effectively managed to
ensure that access is not impeded?
Is this due to a shift in care to walk-in clinics or family
physician offices, hospital restructuring, or changes to
how doctors are paid?
What can be done to manage these peaks better and
avoid congestion in the ED?
If this trend continues, what will the impact be on EDs in
ten years as the general population ages?
Does having more highly trained physicians working in
EDs improve quality of care?
What policy options exist to reduce the future workload
on EDs generated by the elderly population, such as
improved access to primary care or chronic disease
Will we have enough physicians to provide the services we
need, and to allow for sustainable call schedules in smaller
The ED setting exposes physicians to a challenging range
of acute illnesses and provides them with the opportunity
for peer contact and support. If family physicians continue
to withdraw from ED work, what impact will this have on
their ability to recognize and manage these diseases?
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