by Lauren Dubinsky
, Senior Reporter | April 08, 2015
More patients are visiting the emergency department for chronic conditions and fewer are visiting for injuries, according to a new University of California San Francisco study. The results were published in the April edition of Health Affairs.
"These findings emphasize the changing role of the ED in the U.S. health care system, and the increasing reliance that patients and providers place on the ED as a place for diagnosis and treatment of complex conditions," Dr. Renee Y. Hsia, lead author and professor of emergency medicine at UCSF and director of health policy studies in the UCSF Department of Emergency Medicine, told DOTmed News.
Other studies have found that the ED is crowded because of uninsured patients who come for "unnecessary care" but this study shows that many patients with access to primary care physicians still come to the ED and are actually often referred there for care, said Hsia. "This suggests that providers are also using the ED as a place to direct their patents for management of conditions that they may not be able to handle well in their own setting," she added.
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The researchers analyzed all California ED visits from 2005 and 2011 and found that the rate of non-injury diagnoses rose by 13.4 percent. The diagnoses that experience the highest growth were nervous system disorders, symptoms of abdominal pain and gastrointestinal system diseases.
But on a positive note, the study did find that the overall ED visit rate decreased by 0.7 percent throughout the study’s time frame.
Younger patients between ages five and 44 had more non-injury diagnoses than the 45 and older population, who experienced more injury-related diagnoses. Since the population is steadily aging, there is now a spike in falls and other trauma among older patients.
The study also found that mental health conditions were the main diagnoses among the uninsured, Medicaid and privately insured populations. That means that the ED is also becoming a place that cares for patients with mental illnesses.
The researchers believe that the findings of the study can assist policy makers and ED physicians to redesign the structure, staffing and funding of EDs. It also highlights the increasing importance of EDs for providing care for complex conditions and the “changing nature of illness in the population needing immediate medical attention.”
"It reflects the reality of how central the ED is to our health care system," said Hsia. "We know that about half of hospital admissions come through the ED, so appropriately resourcing the ED is important so that we can treat all the sick patients with time-sensitive conditions with quality care."Back to HCB News