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Crisis Standards of Care
Volume 5: Alternate Care Systems
CSC Alternate Care Systems
Approximately 89 percent of health care is delivered in outpatient settings. Of an estimated 1.2 billion outpatient visits in 2007, fewer than 17 percent were to emergency departments or hospital-associated clinics; total hospitalizations were 34.4 million in the same year. Especially during an epidemic, failure to leverage outpatient resources may result in catastrophic overload of inpatient and hospital-affiliated resources.

Current federal, state, and local disaster planning efforts have focused on integrating the hospital system and public health agencies. Following recent mass evacuations of residential care facilities (for hurricanes and fires), increased attention has been paid to outpatient nursing and long-term care units; however, individual and small-group practice settings have received little attention or integration into broader disaster planning efforts.