Navigation Links
ER docs are key to reducing health care costs

WASHINGTON Emergency physicians are key decisionmakers for nearly half of all hospital admissions, highlighting a critical role they can play in reducing health care costs, according to a new report from the RAND Corporation.

Hospital admissions from the ER increased by 17 percent over seven years, accounting for nearly all the growth in hospital admissions between 2003 and 2009. Hospital inpatient care is a key driver of health care costs, accounting for 31 percent of the nation's health care expenses.

"This report tells policymakers and hospital administrators that they should pay closer attention to the role that emergency physicians play in evaluating, managing and preventing hospital admissions," said Dr. Andy Sama, president of the American College of Emergency Physicians. "Clearly, emergency departments must be fully integrated in health care delivery systems for both inpatient and outpatient care."

Hospital admissions grew from 34.7 million to 36.1 million, offset by a 10 percent decline in admissions from primary care physicians and clinical referrals. Nearly all of the increase was from "non-elective" admissions from the emergency department a rate 3.8 times the rate of population growth. Increased admissions were highest among people ages 65 and older. Self-pay patients were less likely to be admitted to the hospital than patients with health insurance. The role ERs and emergency physicians play in deciding who to admit to the hospital is critical to hospital cost savings, since the average cost of an inpatient stay ($9,200) is roughly 10 times the average cost of a comprehensive emergency visit ($922).

The report also found that emergency care is important to physicians as well as patients. Four in five people who contacted a primary care physician or other medical provider before seeking emergency care were told to bypass their doctor's office and go directly to the emergency room. The RAND team found evidence that primary care physicians are increasingly relying on ERs to evaluate and, if necessary, hospitalize their sickest and most complex patients.

"One of the most important elements of patient-centered care is deciding when individuals can't be safely managed in community settings," said Dr. Wes Fields, chair of the Emergency Medicine Action Fund, which sponsored the RAND research. "Emergency physicians are trained to rapidly evaluate a wide array of conditions that are complex or time sensitive, and facilitate observation or admission of the most acutely ill patients. The study also suggests that the biggest challenge facing most ERs is trying to meet the needs of the growing population of Medicare age. Whether you live in a big city or a rural area, trying to find the right level of care for seniors with not one but several medical conditions is an ongoing struggle that plays out nights, weekends, and holidays at the front door to the hospital. Emergency departments are as vital as medical homes in every medical community."

Lack of access to follow-up care is a top concern that influences the decision of emergency physicians to admit particularly fragile patients to the hospital, rather than take a chance that they will fall through the cracks and suffer harm.

"The Rand report highlights the lack of follow-up care for many patients who come to the ER," said Dr. Alex Rosenau, president-elect of ACEP. "Sometimes physicians can send people home if they know their patients will be able to get their medications, have support from family or friends and can schedule follow-up medical visits. Sometimes these resources don't exist and we make decisions to admit. Emergency physicians coordinate transitions of care every day in hospitals across the country, filling the gaping holes in our health care system."

The report recommends that hospital administrators, policymakers, payers and federal research agencies recognize the current reality in emergency department operations and the role they play in coordinating care for millions of patients.

The four percent of America's doctors who staff hospital emergency departments provide;

  • 11 percent of all the outpatient visits in the United States,
  • 28 percent of all acute care visits,
  • half of the acute care visits by Medicaid and CHIP beneficiaries and
  • two-thirds of all acute care visits by the uninsured.

"Efforts to reduce non-urgent and non-emergency use of emergency departments oversimplify a complex problem, and should instead focus on increasing access to affordable options outside the emergency room," said Dr. Sama.

Efforts to shift care into other facilities, such as retail clinics, have not always been successful because of the limitations of other facilities. For example, retail clinics lack diagnostic testing, are unable to admit patients to the hospital and won't see uninsured patients who can't pay cash.


Contact: Julie Lloyd
American College of Emergency Physicians

Related medicine news :

1. New program successful in reducing service and substance use among frequent health care users
2. Reducing Respiratory Virus in Preemies Lessens Wheezing: Study
3. Local laws key to reducing dangers of lead poisoning
4. Study evaluates effect of different supplements on reducing risk of progression to advanced AMD
5. Cleveland Clinic research shows Internet-based program effective in reducing stress
6. Foul-smelling gas shows health benefits in reducing joint swelling
7. ACE, the Accreditation for Cardiovascular Excellence, cited for Improving Quality and Reducing Costs
8. NetDryers Now Offering Restroom/Hand Drying Assessment Reports to Assist Organizations in Reducing Paper Towel Costs
9. hCGTreatments / Diet Doc hCG Diets & Weight Loss Plans Reports Newly Designed Prescription hCG Diet Plans Beneficial in Reducing Painful And Chronic Joint Pain
10. Nurses can play key role in reducing deaths from worlds most common diseases
11. Protein synthesis blocker may hold key to reducing effects of traumatic events
Post Your Comments:
(Date:6/27/2016)... ... , ... "FCPX editors can now reveal their media with growing colorful split ... Austin - CEO of Pixel Film Studios. , ProSlice Color brings the split ... now reveal the media of their split screens with growing colorful panels. , ProSlice ...
(Date:6/26/2016)... ... , ... Quality metrics are proliferating in cancer care, and are derived from ... of the beholder, according to experts who offered insights and commentary in the current ... For the full issue, click here . , For the American Society of ...
(Date:6/26/2016)... ... June 26, 2016 , ... Many women are confused ... endometriosis. These women need a treatment plan to not only alleviate symptoms and ... help for preservation of fertility and ultimately achieving a pregnancy. The specialists at ...
(Date:6/25/2016)... ... 2016 , ... First Choice Emergency Room , the largest network of ... Medical Director of its new Mesquite-Samuell Farm facility. , “We are pleased to ... said Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. ...
(Date:6/24/2016)... Angeles, CA (PRWEB) , ... June 24, 2016 , ... ... surgery procedures that most people are unfamiliar with. The article goes on to state ... procedures, but also many of these less common operations such as calf and cheek ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... 2016 , , , WHEN: ... 2016 , , , , LOCATION: , , , Online, ... , , EXPERT PANELISTS:  , , , Frost & Sullivan,s Global ... Bird; Senior Industry Analyst, Divyaa Ravishankar and Unmesh Lal, Program Manager ... pharmaceutical industry is witnessing an exceptional era. Several new demand spaces, ...
(Date:6/23/2016)... , June 23, 2016  Guerbet announced today ... Inc.,s Supplier Horizon Award . One ... Guerbet was recognized for its support of Premier members ... through clinical excellence, and commitment to lower costs. ... receive this recognition of our outstanding customer service from ...
(Date:6/23/2016)... The Biotechnology industry might still ... great opportunities to investors. assesses the recent performances ... XON ), Vertex Pharmaceuticals Inc. (NASDAQ: ... ARNA ), and Regeneron Pharmaceuticals Inc. (NASDAQ: ... your complimentary trade alerts at: ...
Breaking Medicine Technology: