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Charges for emergency room visits often based on incorrect assumptions
Date:3/20/2013

t of all ER visits. At 12.5 percent of these visits, patients actually required admission to the hospital. And of those patients who were admitted, 11 percent went to the critical care unit, and more than 3 percent went straight to the operating room. Most of those patients had at least one abnormal triage vital sign recorded most often an abnormal respiratory rate and blood pressure readings.

Some of the most common "nonemergency" reasons for visiting the ER included toothache, skin rash, fever, diarrhea, earache and abdominal pain including cramps and spasms.

The authors said that based on their findings, if a triage nurse were to redirect patients away from the ER based on so-called nonemergency complaints, 93 percent of those patients would not have had primary care-treatable diagnoses.

"An example of the problem would be a 50-year-old patient who wakes in the middle of the night with chest pain," said senior author Renee Y. Hsia, MD, an assistant professor of emergency medicine at UCSF and an attending physician in the emergency department at San Francisco General Hospital & Trauma Center. "He goes to the emergency department and turns out, luckily, he's not having a heart attack but instead is diagnosed with acid reflux. It would be easy for a policymaker to look at his discharge diagnosis of 'acid reflux' and call that completely unnecessary, but the policymaker doesn't know that the patient actually came in with a presenting complaint of chest pain. And we think such a visit is an appropriate one, and that such patients should come to the ER to seek care."


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Contact: Elizabeth Fernandez
elizabeth.fernandez@ucsf.edu
415-502-6397
University of California - San Francisco
Source:Eurekalert  

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