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Hospital emergency departments gaining in importance, study finds
Date:5/20/2013

s and emergency department physicians.

The study found that while admissions to U.S. hospitals grew more slowly than the nation's overall population from 2003 and 2009, nearly all of the growth over the period was caused by a 17 percent increase in unscheduled admissions made from emergency departments. That growth more than offset a 10 percent drop in admission from doctors' office and other outpatient settings.

Researchers say the findings suggest that office-based physicians are directing to emergency departments some patients they previously would have admitted to the hospital themselves.

The study also found that emergency departments increasingly support primary care providers by performing complex diagnostic workups that cannot be done in physician offices. In addition, emergency departments supplement primary care providers by handling overflow, after-hours cases and weekend demand for medical care.

These changes mean that emergency physicians now serve as the major decision maker for about half of all hospitals admissions in the United States. Hospital admissions account for most of hospital revenue and inpatient medical care accounts for 31 percent of nationwide health spending, making emergency room physicians a major nexus in influencing health care costs.

Researchers found that most people who seek care in an emergency department do so because they perceive no viable alternative, not because it was convenient. Researchers say the finding suggests that efforts to reduce non-urgent visits to emergency departments should focus on assuring timely access to primary care and less-expensive forms of care, rather than blocking access to emergency departments.

"We believe there needs to be more effort to integrate the operations of emergency departments into both inpatient and outpatient care systems," said Kristy Gonzalez Morganti, the study's lead author and a policy researcher at RAND.

Ways to
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Contact: Warren Robak
robak@rand.org
310-451-6913
RAND Corporation
Source:Eurekalert

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