Greater volume, intensity of care strains hospital EDs

A new study by the American Hospital Association has concluded that Medicare patients are receiving services in hospital emergency departments at greater rates and require more intensive care than only a few years ago, impacting the cost of providing treatment.

The average number of ED visits per 1,000 fee-for-service Medicare beneficiaries rose almost 12 percent between 2006 and 2010, while severity of illness treated in EDs rose by 9 percent, according to the report analyzing Medicare claims data and compiled by The Moran Company.

"The reality is that seniors who come to the hospital ED are sicker and have more chronic illnesses," said AHA CEO Rich Umbdenstock in a statement. "Hospitals are striving to meet their communities' needs, which means caring for patients who need more--and more intensive services--than ever before."

In addition to the increasing use of ED services, the number of level 5 CPT claims codes--the most intense and expensive codes--has nearly doubled between 2006 and 2010.

The report noted that the movement toward hospitals placing more patients in observation care also may be driving the overall ED trends, citing that those patients tend to be sicker than the typical emergency room patient.

However, a recent Truven Analytics study noted a large number of ED visits are unnecessary. More than 70 percent of emergency department visits from patients with employer-sponsored insurance coverage are for nonemergency conditions or conditions preventable through outpatient care, FierceHealthcare reported last week.

Although the AHA study did not provide any specific cost data, the hospital group noted policymakers have expressed concerns the rising severity of illness among Medicare patients treated in EDs is driving up spending.

To learn more:
- here's the AHA report (.pdf)
- read the AHA statement (.pdf)

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