More than 1 million emergency department visits in Minnesota during 2012 may have been preventable, according to a report from the state Department of Health (MDH).
In 2012, Minnesota residents used a hospital ED approximately 1.8 million times. MDH officials analyzed that year's claims and found 1.2 million ED visits, 50,000 hospital admissions and 22,000 readmissions were potentially preventable, for a combined cost of $1.9 billion, or nearly 5 percent of total healthcare spending in the state.
Several conditions made up the bulk of preventable events in each category. For example, upper respiratory tract infections were the most common reason for preventable ED visits, at 9 percent, followed by abdominal pain with 7 percent. A study published in JAMA Internal Medicine earlier this year found chest pain is also a major driver of unnecessary ED visits, FierceHealthcare previously reported.
Researchers found Medicaid beneficiaries were overrepresented among ED data, making up 14 percent of the population but 40 percent of ED visits in 2012. Moreover, as many as 50,000 state residents may have made four or more avoidable ED visits, State Health Economist Stefan Gildemeister told Minnesota Public Radio.
Meanwhile, pneumonia was the top cause of potentially preventable hospital admissions, at 13 percent, while heart failure was the most common cause of potentially preventable readmissions, at 6.6 percent.
Researchers made several recommendations for cutting preventable healthcare events and the associated costs, including:
- Increasing patient access to high-quality preventive outpatient care.
- Improving care coordination, especially between hospitals and long-term care providers, which is also a top priority for the U.S. Department of Health and Human Services.
- Leveraging emerging providers such as community health workers or community paramedics, to coordinate care and guide patients to social supports that could prevent admissions and ED visits. In California, medical homes for low-income, high-risk patients significantly reduced unnecessary ED visits, while in Denver, smaller "urgent care" ambulances have reduced spending and could avert unnecessary ED use.
- Maintain consistent, robust patient and family engagement.