Which delivery system factors drive ED use?

 

Emergency department use is at a historic high. Nearly one-half of all nonelective admissions go through the ED, according to one source. The following are factors driving ED use, according to a brief from CMS and the Children's Health Insurance Program Payment Advisory Commission:

  • Patient's perception of need for prompt care
  • Provider's perception of need for prompt care
  • Perceived severity of the condition
  • Availability and accessibility of ED relative to other sites of care
  • Physician referrals to the ED
  • Increase in nonemergency, primary care referrals to ED for diagnostic work-ups
  • Decline in hospital admissions from office-based physician practices
  • Move of some historical inpatient services to the ED setting
  • Improvements in ED-based rapid diagnostic technology

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