Hospitals and health systems have been trying to curb nonurgent visits to the emergency department; however, researchers say that approach will save far fewer healthcare dollars than reducing hospital admissions for patients already in the ED, according to a paper published Thursday in Annals of Emergency Medicine.
Acknowledging that ED visits for emergencies, intermediate/complex conditions and minor injuries/illnesses offer various potential to cut expenditures, the paper suggests targeting cost-saving efforts toward avoidable preventable admissions from intermediate/complex conditions.
"The focus on nonurgent ER visits distracts from the potential savings that do exist in the area of hospital admissions," lead study author Peter Smulowitz, M.D., of Boston's Beth Israel Deaconess Medical Center, said in a statement.
Complex acute and chronic disease represents the greatest potential cost savings, as reducing hospital admissions from this area by 10 percent to 25 percent could save up to 2.5 percent of total health expenses, according to the paper.
Meanwhile, cutting visits for minor injuries and illnesses in half will only lead to savings between 0.25 percent and 0.8 percent.
To reduce hospitals admissions from the ED, hospitals can increase their use of observation units. They also can avoid unnecessary hospitalizations by facilitating treatment for patients at home or in short-term facilities via teamwork among emergency physicians, case managers and community-based services.
Nevertheless, hospital EDs must retain the ability to treat true emergencies. "No matter how many improvements are made in the quality and efficiency of healthcare delivery, there will always be emergencies," the paper states.