Contrary to popular belief, reducing nonurgent visits to the emergency department — or visits deemed inappropriate for the ED — may not produce cost savings, according to a study in Annals of Emergency Medicine (pdf).
Researchers created a framework in which ED visits were classified as emergency, such as trauma; intermediate/complex, such as congestive heart failure; or minor injury/illness, such as a sprain. The researchers used a modification of the Billings NYU algorithm and CDC data to estimate the percentage of ED visits for each category and the potential cost savings.
The authors estimated injuries and illnesses account for approximately 0.42 percent to 1.6 percent of overall expenses. The study showed reducing visits in this category, even by 50 percent, would reduce total health expenses by only 0.24 percent to 0.8 percent.
In contrast, the researchers estimated 31 percent to 57 percent of ED visits are for intermediate/complex conditions and that these visits would generate 10 percent of total health expenses. Decreasing visits in this category, even by only 10 percent to 25 percent, could save approximately 1 percent to 2.5 percent of total health costs, according to the study.
The authors recommended hospitals focus on reducing admissions and improving ED efficiency rather than limiting low-acuity cases to cut costs and improve patient care in the ED.
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Researchers created a framework in which ED visits were classified as emergency, such as trauma; intermediate/complex, such as congestive heart failure; or minor injury/illness, such as a sprain. The researchers used a modification of the Billings NYU algorithm and CDC data to estimate the percentage of ED visits for each category and the potential cost savings.
The authors estimated injuries and illnesses account for approximately 0.42 percent to 1.6 percent of overall expenses. The study showed reducing visits in this category, even by 50 percent, would reduce total health expenses by only 0.24 percent to 0.8 percent.
In contrast, the researchers estimated 31 percent to 57 percent of ED visits are for intermediate/complex conditions and that these visits would generate 10 percent of total health expenses. Decreasing visits in this category, even by only 10 percent to 25 percent, could save approximately 1 percent to 2.5 percent of total health costs, according to the study.
The authors recommended hospitals focus on reducing admissions and improving ED efficiency rather than limiting low-acuity cases to cut costs and improve patient care in the ED.
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Study: Practice Intensity Drives Increased ED Crowding