Most unscheduled hospital admissions come through ER

More than three-quarters (81.8 percent) of unscheduled admissions to the hospital now come through the emergency department, a large increase from the last decade when only 64.5 percent of unscheduled admissions came through the ED, the American College of Emergency Physicians (ACEP) announced.

A study published in Medical Care reinforces recent findings by the RAND Corporation emphasizing emergency physicians' growing role in healthcare, the ACEP noted.

"The ER was the source of admission for a wide variety of clinical conditions, from medical and surgical disease to mental illness," lead study author Keith Kocher, M.D., of the Department of Emergency Medicine at the University of Michigan said in the announcement. "It was also the source of admission for more vulnerable populations like the elderly, minorities and the uninsured."

Emergency department admissions increased at the expense of direct admissions from clinics or doctors' offices, which declined from 31 percent to 14 percent of unscheduled admissions, according to the study that compared hospital admissions from 2000 to 2009.

"Our study and the RAND study demonstrate that the emergency department has become the major portal for unscheduled hospitalizations," said Kocher in the study. "Administrators and policy makers would be advised to focus their attention on physicians and caregivers in the emergency department who make more and more of these decisions to admit."

The RAND report described the ER and its staff as a "key decision maker" for roughly half of all inpatient hospital admissions, serving as the safety net for patients who can't get care anywhere else.

As Forbes rounded up, emergency physicians working in hospital EDs "represent 4 percent of U.S. physicians, but provide 28 percent of all acute care treatment, 11 percent of all the outpatient treatment in the U.S., along with 50 percent of acute care management to Medicaid and CHIP beneficiaries and over 66 percent of all acute care treatment to the uninsured."

To learn more:
- read the ACEP announcement
- see the RAND study
- see the Forbes article

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