EDs Responsible for Half of Hospital Admissions, RAND Report Finds
Emergency departments currently drive about 50% of all U.S. hospital admissions, and EDs were responsible for nearly all admissions growth between 2003 and 2009, according to a studyÂ released Monday by the RAND Corporation,Â The Hill's "Healthwatch" reports.
The report found a 17% increase in unscheduled ED admissions from 2003 to 2009. In contrast, there was a 10-percentage-point decrease in admissions from doctor's offices and other health care provider settings, the study found (Viebeck, "Healthwatch,"Â The Hill, 5/20).
According to researchers, patients typically visit EDs:
- Because they lack health insurance;
- To receive nighttime and weekend care; or
- After being referred by their primary physicians to receive tests.
The report noted that EDs have been a source of care beyond emergency treatment for a while. Arthur Kellerman, one of the study's authors and an emergency physician, said, "It is not just an emergency department, and it hasn't been for 20 years" (Abelson,Â New York Times, 5/20).
According to "Healthwatch," the report points to a trend in which ED physicians are gaining more power as "major decision maker[s]" for a majority of hospital admissions. The report also noted that that power likely will increase as theÂ shortageÂ of primary care physicians worsens.
Study Questions Long-Held Beliefs About ED's Effect on Rising Health Care Costs
The study contrasts a "powerful narrative" about EDs -- that they provide costly care and contribute heavily to rising health care spending, "Healthwatch" reports ("Healthwatch,"Â The Hill, 5/20).
The report concludes that EDs' contribution to rising health care spending is unclear, according to theÂ New York TimesÂ (New York Times, 5/20). Researchers discovered that a greater number of patients with asthma and diabetes visited EDs between 2000 and 2009 but that the number of related hospitalizations did not increase, suggesting that EDs might prevent unnecessary hospital admissions ("Healthwatch,"Â The Hill, 5/20). The study findings "offer early evidence, albeit inconclusive, that EDs are already having a positive impact," the authors wrote.
Further, while ED care might cost more than primary care, patients could benefit from diagnostic testing when compared with receiving care from several doctors or undergoing multiple tests to determine their illness, according to theÂ TimesÂ (New York Times, 5/20).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.