title: Emergency department enlargement in China: exciting or bothering.
abstract: BACKGROUND
  Emergency department (ED) enlargement became a trend with its development. However, there came some problems such as ED overcrowding and increasing medical disputes. Here we did a survey about the development tendency of EDs in 3A grade hospitals in China, analysed the problems we facing and rendered some solutions combining some special characteristics in China.
  
  
  METHODS
  We randomly selected 17 3A grade general hospitals from 12 provinces from the 50 members of Chinese College of Emergency Physician. A questionnaire survey was conducted. The basic information and problems of EDs were collected and analysed.
  
  
  RESULTS
  The gross area, the number of beds and the attention paid by the hospitals of EDs increased during the development, so did the patients admitted to EDs, also more doctors and nurses devoted into emergency medicine. But it had become more difficult for doctors to admit ED patients to inpatient wards. Besides the problem of increasing crowding degree, EDs faced more medical disputes and complains during the development.
  
  
  CONCLUSIONS
  ED expanding was the result of emergency medicine development, but the enlargement of ED should be more rational. We should improve our doctors' medical skills, optimize the health system, pay more attention to preventive medicine and push hard for health-care reform instead of forcing ED enlargement to satisfy the need for ED.
authors.affiliation: 1 Department of Emergency Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China ; 2 Department of Emergency Medicine, Beijing Chao-yang Hospital, Beijing 100020, China ; 3 Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China ; 4 Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, USA.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: 1 Department of Emergency Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China ; 2 Department of Emergency Medicine, Beijing Chao-yang Hospital, Beijing 100020, China ; 3 Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China ; 4 Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, USA.
authors.forename: Chen
authors.initials: C
authors.lastname: Li
authors.affiliation: 1 Department of Emergency Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China ; 2 Department of Emergency Medicine, Beijing Chao-yang Hospital, Beijing 100020, China ; 3 Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China ; 4 Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.affiliation: 1 Department of Emergency Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China ; 2 Department of Emergency Medicine, Beijing Chao-yang Hospital, Beijing 100020, China ; 3 Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China ; 4 Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, USA.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.affiliation: 1 Department of Emergency Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China ; 2 Department of Emergency Medicine, Beijing Chao-yang Hospital, Beijing 100020, China ; 3 Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China ; 4 Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, USA.
authors.forename: Liangliang
authors.initials: L
authors.lastname: Zheng
authors.affiliation: 1 Department of Emergency Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China ; 2 Department of Emergency Medicine, Beijing Chao-yang Hospital, Beijing 100020, China ; 3 Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China ; 4 Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, USA.
authors.forename: Dongqi
authors.initials: D
authors.lastname: Yao
authors.affiliation: 1 Department of Emergency Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China ; 2 Department of Emergency Medicine, Beijing Chao-yang Hospital, Beijing 100020, China ; 3 Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China ; 4 Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, USA.
authors.forename: Yangyang
authors.initials: Y
authors.lastname: Fu
authors.affiliation: 1 Department of Emergency Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China ; 2 Department of Emergency Medicine, Beijing Chao-yang Hospital, Beijing 100020, China ; 3 Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China ; 4 Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, USA.
authors.forename: Huadong
authors.initials: H
authors.lastname: Zhu
authors.affiliation: 1 Department of Emergency Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China ; 2 Department of Emergency Medicine, Beijing Chao-yang Hospital, Beijing 100020, China ; 3 Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China ; 4 Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, USA.
authors.forename: Shubin
authors.initials: S
authors.lastname: Guo
authors.affiliation: 1 Department of Emergency Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China ; 2 Department of Emergency Medicine, Beijing Chao-yang Hospital, Beijing 100020, China ; 3 Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China ; 4 Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, USA.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Wang
authors.affiliation: 1 Department of Emergency Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China ; 2 Department of Emergency Medicine, Beijing Chao-yang Hospital, Beijing 100020, China ; 3 Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China ; 4 Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Walline
authors.affiliation: 1 Department of Emergency Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China ; 2 Department of Emergency Medicine, Beijing Chao-yang Hospital, Beijing 100020, China ; 3 Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China ; 4 Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, USA.
authors.forename: Xuezhong
authors.initials: X
authors.lastname: Yu
keywords: Emergency department (ED); access block; enlargement; overcrowding