THE ACUTE CARE CONTINUUM IN CALIFORNIA

California's acute care system provides several essential services and compares favorably with other developed countries. For developing systems, a critical analysis of the California model suggests: (1) ambulatory patients require timely access to urgent and continuing primary care in communities to allow the ED to focus on more essential services; (2) outcomes from highly specialized care in California support the wider consensus that time-sensitive, life-threatening emergency conditions are best managed within regionalized systems of care; (3) ED-oriented care teams are well positioned to rapidly evaluate and treat patients with acute exacerbations of chronic conditions, reducing the need for more costly hospital admission or readmission; (4) frequent visitors to ED's due to poorly controlled behavioral health require their own urgent treatment pathways to preserve ED capacity.