The rate of emergency department (ED) visits in California for non-injuries has risen while the rate of visits for injuries has dropped, according to a new study led by UC San Francisco that documents the increasing amount of care provided in ED for complex, chronic conditions.
The research, which appears in the April edition of Health Affairs, shows that the ED visit rate for injuries decreased by 0.7 percent during the study’s timeframe — from 2005 to 2011 — while the rate of ED visits for non-injury diagnoses rose 13.4 percent. Among non-injury diagnoses, gastrointestinal system diseases, nervous system disorders, and symptoms of abdominal pain experienced the highest growth in the rate of ED visits, the study found.
The research shows the growing importance of non-trauma cases in the ED, the authors said, and it provides an opportunity to better understand the health of people as well as shifting patterns of care, especially among vulnerable populations.
Other key findings from the study include the following:
- While the rate of ED visits for injuries rose more slowly than non-injury diagnoses among Medicaid beneficiaries and the privately insured, the rate decreased among the uninsured.
- Medicare beneficiaries had a similar percent growth for injury and non-injury diagnoses. Younger patients 5-44 years old experienced more non-injury related diagnoses, compared to the older population (45 and older) who had more injury-related diagnoses.
- The rate of growth in mental health conditions as a primary diagnosis was significant among the uninsured, Medicare beneficiaries, and the privately insured, showing the ED is also serving as a place of care for patients with mental illness.
The research shows the complexity of emergency care, and it may help policy makers and emergency care physicians to reshape the structure, staffing and funding of emergency departments, the researchers conclude.
Source: UCSF April 6, 2015
Remote Patient Monitoring for Chronic Condition Management: Leveraging Technology in a Value-Based System chronicles the evolution of the CHRISTUS RPM pilot, which is framed around a Bluetooth®-enabled monitoring kit sent home with patients at hospital discharge. This 25-page report reviews the multi-state and international integrated delivery network’s impressive early returns in cost of care, 30-day readmission rates and patient satisfaction, as well as challenges of program expansion.