Open Access Highly Accessed Review

The efficacy and value of emergency medicine: a supportive literature review

C James Holliman1*, Terrence M Mulligan2, Robert E Suter3, Peter Cameron4, Lee Wallis5, Philip D Anderson6 and Kathleen Clem7

Author Affiliations

1 The Center for Disaster and Humanitarian Assistance Medicine, Uniformed Services University of the Health Sciences, and George Washington University School of Medicine and Health Sciences, Bethesda, MD, USA

2 The Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA, and The Division of Emergency Medicine, Stellenbosch University, Capetown, South Africa

3 The Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, and the Division of Emergency Medicine, University of Texas Southwestern, Dallas, TX, USA

4 The Department of Emergency Medicine, the Alfred Hospital, Monash University, Melbourne, Australia

5 The Division of Emergency Medicine, Stellenbosch University, Capetown, South Africa

6 The Department of Emergency Medicine, Beth Israel Deaconess Medical Center and the Harvard Medical School, Boston, MA, USA

7 The Department of Emergency Medicine, Loma Linda University, Loma Linda, CA, USA

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International Journal of Emergency Medicine 2011, 4:44  doi:10.1186/1865-1380-4-44

Published: 22 July 2011

Abstract

Study objectives

The goal of this study was to identify publications in the medical literature that support the efficacy or value of Emergency Medicine (EM) as a medical specialty and of clinical care delivered by trained emergency physicians. In this study we use the term "value" to refer both to the "efficacy of clinical care" in terms of achieving desired patient outcomes, as well as "efficiency" in terms of effective and/or cost-effective utilization of healthcare resources in delivering emergency care. A comprehensive listing of publications describing the efficacy or value of EM has not been previously published. It is anticipated that the accumulated reference list generated by this study will serve to help promote awareness of the value of EM as a medical specialty, and acceptance and development of the specialty of EM in countries where EM is new or not yet fully established.

Methods

The January 1995 to October 2010 issues of selected journals, including the EM journals with the highest article impact factors, were reviewed to identify articles of studies or commentaries that evaluated efficacy, effectiveness, and/or value related to EM as a specialty or to clinical care delivered by EM practitioners. Articles were included if they found a positive or beneficial effect of EM or of EM physician-provided medical care. Additional articles that had been published prior to 1995 or in other non-EM journals already known to the authors were also included.

Results

A total of 282 articles were identified, and each was categorized into one of the following topics: efficacy of EM for critical care and procedures (31 articles), efficacy of EM for efficiency or cost of care (30 articles), efficacy of EM for public health or preventive medicine (34 articles), efficacy of EM for radiology (11 articles), efficacy of EM for trauma or airway management (27 articles), efficacy of EM for using ultrasound (56 articles), efficacy of EM faculty (34 articles), efficacy of EM residencies (24 articles), and overviews and editorials of EM efficacy and value (35 articles).

Conclusion

There is extensive medical literature that supports the efficacy and value for both EM as a medical specialty and for emergency patient care delivered by trained EM physicians.