ER super-users: Needs are severe but temporary

The conditions and symptoms that drive many healthcare "super-users" to seek care in and out of the emergency room are intense but don't last long, according to a new study in Health Affairs.

The findings are significant as many hospital leaders focus on efforts to divert super-users to other care settings to improve care and control rising healthcare costs

Researchers, led by Tracy L. Johnson, director of healthcare reform initiatives at Denver Health, analyzed 2011-2013 data for 4,774 Denver Health super-users, all of whom were either uninsured or covered under public programs. They found that fewer than 50 percent of patients who were classified as super-users in May 2011 met the definition seven months later. By the end of a year, only 28 percent remained.

These findings, researchers wrote, indicate many super-users' medical conditions are temporary, and previous research on the subject of super-users may have hidden this widespread instability. 

In addition, the research team found wide variation in the super-user profile, with 18 percent of subjects lacking common characteristics such as homelessness or mental conditions. In the case of super-users who do have mental conditions, the segregation of financing and delivery systems for mental and physical health services in many states' Medicaid programs is a major hurdle.

To reduce the number of healthcare super-users, researchers recommend organizations embed complex case managers in primary care practices, community-based approaches and ambulatory intensive care units. 

To learn more:
- read the study abstract