|Your Current Location: SMA Informatics Home
Study: ER visits up more that 50% in 13 years
by Roy Edroso
They're not sure why, but use of the emergency department by patients without other options seems a likely cause.
Researchers used data from approximately eight million hospital stays a year culled from the Nationwide Inpatient Sample (NIS).
They found that while "the number of hospital admissions increased by 15.0%" between 1993 and 2006, "admissions from the ED increased by 50.4%, from 11.5 million to 17.3 million," according to their report in the New England Journal of Medicine.
Their appendix reveals that ER admissions for pneumonia increased 28.8%, admissions for septicemia increased 24%, and admissions for "Complications of Device, Grant of Implant" increased by 72.6%.
The researchers consider, among other possible causes for the uptick, the "frequently cited hypothesis" that "overuse of the ED for conditions that would more appropriately be treated in primary care providers' offices could lead to increased admission rates — either because reduced access to primary care leads to worsening of patients' conditions and greater need for emergency hospitalization or because emergency physicians are more likely than primary care providers to admit patients to the hospital."
The researchers don't make a judgement on this, but it seems to fit with CDC's survey earlier this year, in which most ER patients reported they were there because of "lack of access to other providers," and with the states' efforts to restrict Medicaid patients' ER use.
They also consider that "the trend could be driven by changes in the organization of medical services that favor the rapid diagnostic technologies and early treatment available in the ED."
In any case, the researchers conclude that "the ACA's expansion of insurance coverage, the reality of an aging population with complex conditions, and the expectation of timely, specialized, and coordinated care mean that the trend toward increasing percentages of ED admissions is unlikely to be reversed."