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Examining National Trends in Unscheduled Hospitalizations

Examining National Trends in Unscheduled Hospitalizations

Published data demonstrate that hospitalizations represent a significant portion of the annual expenditures for the United States healthcare system. A recent analysis by the RAND Corporation showed that emergency physicians are playing a greater role in healthcare beyond the services they provide in the ED. “Gaining a better understanding of recent changes in the sources of unscheduled ED admissions may provide opportunities to improve the quality and cost of inpatient care,” says Keith E. Kocher, MD, MPH. Analyzing the Effects In the journal Medical Care, Dr. Kocher and colleagues published an observational study examining the sources of unscheduled hospitalization over a 10-year period using data from the Nationwide Inpatient Sample. They also assessed implications for inpatient mortality and length of stay. Unscheduled hospitalizations were categorized as those related to transfers, direct admissions from outpatient providers, and the ED. Study results showed that about 82% of unscheduled admissions to the hospital came through the ED in 2009, representing a sharp increase from the 65% rate that was observed in 2000. Unscheduled hospitalizations arising from direct admissions and the ED changed substantially, while those due to transfers remained relatively stable. Direct admissions from clinics or doctors’ offices declined from about 31% to 14% of unscheduled admissions. Lower Mortality, Shorter Stays “In 2009, hospitalizations through the ED were associated with lower mortality overall when compared with direct admissions,” says Dr. Kocher. “These hospitalizations were also associated with a shorter hospital length of stay. These findings occurred despite a higher severity illness among patients and a greater chronic disease burden in 2009. It’s remarkable that patients admitted to the hospital from the ED...
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