Will targeting high-risk patients curb frequent fliers?

Focusing on so-called frequent fliers--patients regularly admitted to the hospital--won't solve the problem of rising emergency admissions, according to U.K. researchers in a BMJ online study published yesterday.

Although providers target high-risk patients to reduce emergency hospital admissions, most admitted patients come from low- and medium-risk groups, according to Martin Roland and Gary Abel from the Cambridge Centre for Health Services Research. The researchers further noted that "misconceptions may lead to naïve or unrealistic expectations of what can be achieved."

Instead of exclusively focusing on high-risk patients, the researchers recommend targeting interventions at larger populations of patients, such as elderly patients.

Targeting high-risk populations as "frequent fliers" has been a priority for many hospitals, under the assumption that people admitted to the hospital regularly suggest poor outcomes and eat into healthcare costs.

A Journal of the American Medical Association study last year, for instance, found that 2.9 percent of frequent flier pediatric patients accounted for nearly 20 percent of overall admissions and nearly one-quarter of all inpatient charges.

Such data have compelled hospitals to reengineer their case management process to set its sights on high utilizers of the emergency department and hospital services.

As Roland and Abel noted, primary and secondary care doctors need to work together to achieve a common set of goals, according to the research announcement.

For more information:
- read the BMJ announcement
- see the study abstract

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