title: State of affairs of emergency medicine in the Veterans Health Administration.
abstract: BACKGROUND
  The Veterans Health Administration (VHA) has reformed its emergency medical services.
  
  
  OBJECTIVE
  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.
authors.affiliation: Departments of Internal Medicine and Emergency Medicine, University of Illinois-Chicago, Jesse Brown VA Hospital, Chicago, IL 60612, USA.
authors.forename: Chad
authors.initials: C
authors.lastname: Kessler
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chen
authors.forename: Curt
authors.initials: C
authors.lastname: Dill
authors.forename: Gary
authors.initials: G
authors.lastname: Tyndall
authors.forename: Mark D
authors.initials: MD
authors.lastname: Olszyk
mesh_terms: D000554:Ambulatory Care Facilities / Q000592:standards; D002568:Certification / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004635:Emergency Medicine / Q000592:standards; D016529:Emergency Nursing / Q000592:standards; D004636:Emergency Service, Hospital / Q000592:standards*; D006787:Hospitals, Veterans / Q000592:standards*; D006801:Humans; D014481:United States; D014493:United States Department of Veterans Affairs / Q000592:standards*; D000078329:Workforce